RESUMO
BACKGROUND: Autofluorescence bronchoscopy (AFB) allows a more sensitive approach to the diagnosis of premalignant and malignant endobronchial lesions than white light bronchoscopy (WLB) can do. AIM: To assess the autofluorescence bronchoscopy and white light bronchoscopy in diagnosing malignant endobronchial lesions. MATERIALS AND METHODS: The design of the study is a retrospective case-control study. Thirty-two parameters were entered into an Excel file and analysed with SPSS v. 21 for Mac book Pro. Endoscopy findings were graded in 4 options and morphological results - in 9 options according to WHO classification. The results are presented using McNemar's test and sensitivity, specificity and positive and negative predictive values as well. RESULTS: Three hundred and three patients were included in the study. Lung cancer was found in 38.3% of the patients using histology and in 35.6% - using cytology. McNemar's test for AFB finding for suspected and malignant lesions OR was 8.333 (95% CI 3.571-23.784) while for WLB OR was 0.128 (95% CI 0.045-0.299). For cytological results OR was 3.800 (95% CI 2.123-7.227) and 3.471 (95% CI 1.996-6.351), respectively. P value was <0.0001 for all tests. Sensitivity for AFB and WLB was 94.83% but specificity was 52.83% and 55.66% if histology was used. For cytology these numbers were respectively 86.11% and 84.26% for sensitivity, and 63.69% and 62.42% for specificity. CONCLUSION: AFB has an advantage over WLB in diagnosing endobronchial malignant lesions. Biopsying suspicious, not only visible malignant lesions, increased diagnostic sensitivity.
Assuntos
Neoplasias Brônquicas/diagnóstico , Broncoscopia/métodos , Carcinoma/diagnóstico , Lesões Pré-Cancerosas/diagnóstico , Idoso , Biópsia , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/patologia , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Estudos de Casos e Controles , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Imagem Óptica , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/patologia , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
As part of a retrospective study on bronchoscopies performed at the Clinic of Pneumonology and Phthisiatry of the University Hospital - Pleven by autofluorescence bronchoscopy we found 3 cases diagnosed with carcinoma in situ. They were treated in different ways - endobronchial electrocoagulation, extraction by forceps biopsy and open surgery, but the result was the same - clinical healing. The paper presents the three clinical cases and the analysis of the treatment.