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Autofluorescence bronchoscope diagnosis for lung nodules and masses.

OBJECTIVE
This study set out to enhance the positive detection rate of lung tumors, diagnosis of nodular lesions and improve the accuracy of lung cancer classification by evaluating the clinical value of autofluorescence bronchoscopy (AFB).


METHODS
Forceps biopsy, brush biopsy, needle aspiration, and washing techniques were performed alone and in combination with AFB among 38 subjects who were analyzed cytologically and histologically.


RESULTS
Our results showed that 33 out of 38 patients were diagnosed with lung cancer, with an overall positive diagnostic rate of 86.8% when the combined methods and AFB was performed; the positive diagnostic rates obtained by forceps, needle aspiration, brush biopsy and washing methods were 68.4%, 84.2%, 55.3% and 36.8%, respectively. Compared to the overall positive rate, the positive diagnostic rates detected by forceps and needle aspiration were not statistically significant (P>0.05). However, the positive rates gained by the brush biopsy and washing method were statistically significant (P<0.01). In addition, we compared the 38 cases evaluated with AFB and 43 cases evaluated with "traditional" white light bronchoscopy (WLB), using the same methods.


CONCLUSIONS
AFB and WLB markedly improved the positive diagnosis rate when combined with forceps and needle aspiration. The overall positive diagnostic rate of lung cancer scanned by WLB was increased from 60.5% to 86.8% (P<0.01) by using the combined methods of forceps, brush biopsy, needle aspiration and washing. Moreover, the accuracy of lung cancer classification combined with cytology and cell immunohistochemistry was improved. These results showed that a variety of inspection techniques and diagnostic technologies effectively play a complementary role in the diagnosis and classification of lung cancer.