Abstract: Poster Presentations |

Utility Of Fibre Optic Bronchoscopy In Diagnosis Of Lung Cancer FREE TO VIEW

Avanti Vigg, MBBS*
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Chest Clinic, Hyderabad, India


Chest. 2004;126(4_MeetingAbstracts):818S. doi:10.1378/chest.126.4_MeetingAbstracts.818S-b
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PURPOSE:  To determine the current diagnostic yield of fibreoptic bronchoscopy (FOB) in the investigation of lung cancer.

METHODS:  This is a retrospective analysis of FOB performed between January 1998 and December 2003 for possible lung cancer at Apollo Hospitals, a tertiary care referral centre in Hyderabad, South India.

RESULTS:  One thousand four hundred and fourteen (1414) patients underwent FOB for possible lung cancer during the study period. There were 1081 males (76.4%) and 333 females (23.6%); mean age was 46.9 yrs + 2.84 SD. Out of 1414 patients, 1131 received a diagnosis of lung cancer (80%; 95% CI: 78-82). Amongst the 1131 diagnosed patients endobronchial tumour was seen in 724 patients (64%). Bronchoscopic appearances suspicious of malignancy was observed in 169 patients (15%) no endobronchial growth was seen in 226 patients (20%). Positive sampling rate when tumour was seen endobronchially was 90%; the yield was 80% by biopsy & 5% each by bronchoalveolar lavage, cytology, transbronchial needle aspiration & brushings. In patients without any endobronchial growth, BAL cytology was positive in 11 patients(5%) The diagnostic yield with transbronchial lung biopsy was 75%(n=170) & with transbronchial needle aspiration was 20% (n=45). Symptomatically, 792 patients (70%) presented with history of haemoptysis. Three hundred & thirty nine patients (30%) were referred because of abnormal Chest X Ray. Clinical correlation of patient’s history & bronchoscopic diagnosis showed a sensitivity of 88.7% and specificity of 66%. Radiological correlationship with diagnosis of lung cancer had a sensitivity of 86.6%; specificity of 51%; positive predictive value of 24.4% and negative predictive value of 93.1% with accuracy of 56%.

CONCLUSION:  Fibreoptic Bronchoscopy when performed for suspected lung cancer had a high overall diagnostic yield. Broncho alveolar lavage, transbronchial lung biopsy & transbronchial needle aspiration can further improve the diagnostic yield.

CLINICAL IMPLICATIONS:  Bronchoscopy performed for suspected lung cancer can yield high diagnostic rate provided it is combined with various modalities.

DISCLOSURE:  A. Vigg, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM




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