Source: Annual Congress 2002 - Lung cancer: epidemiology and clinical characteristics
Disease area: Thoracic oncology

Abstract

Flexible bronchoscopy role in the diagnosis of lung cancer is studied at a large teaching hospital. The aim is to assess the overall performance and variation among bronchoscopists or pathologists in establishing the diagnosis. We studied 429 bronchoscopic procedures performed on 368 patients with eventual diagnosis of lung cancer [109 females (25.4%), mean age 70 years]. Bronchoscopy confirmed diagnosis of lung cancer in 286 cases (67%). We classified all cases into four groups according to the endoscopic finding. These include definite visible tumour(DVT)188, possible tumour(PT) 112, no tumour seen 54 or unknown 63. In the DVT group, bronchial biopsies confirmed carcinoma in 75% of cases, whilst bronchial brushings and washings together were positive in 27% of cases. The combination of histology and cytology confirmed lung cancer diagnosis in 81.9% of cases. In contrast, the overall diagnostic rate in the PT was low at 50.5%. Performance of bronchoscopists was assessed by comparing the number and type of specimens collected and the diagnostic yield. Together, bronchoscopists collected 910 specimens (217 endobronchial biopsies, 666 bronchial brushings and washings, and 27 unknown). Using chi-square test, we observed no statistical difference between bronchoscopists in bronchial biopsy or cytological specimen rate (p=0.6). There was no significant difference in the diagnostic yield of different bronchoscopists (p=0.8). The pattern of reporting of histological and cytological specimens by five pathologists was similar. The histological spectra is in keeping with published data, where we observed 41% squamous cell, 8% adenocarcinoma, 18% anaplastic tumour, 18% small cell. The remained 15% were labelled as non-small cell.

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A. H. Mansur, R. M. Cayton, S. P. Burge (Stoke-on-Trent, Birmingham, United Kingdom). Assessment of flexible bronchoscopy in lung cancer: Audit of practice and diagnostic rate. Eur Respir J 2002; 20: Suppl. 38, 573

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