Background and Objective: The sensitivity and accuracy of white light bronchoscopy (WLB) in airway examination are low. Autofluorescence bronchoscope (AFB) can determine early lesions in bronchial mucosa more sensitiv...Background and Objective: The sensitivity and accuracy of white light bronchoscopy (WLB) in airway examination are low. Autofluorescence bronchoscope (AFB) can determine early lesions in bronchial mucosa more sensitively, but it has seldom performed in China. To assess the clinical value of the AFB in airway examination, we compared the sensitivity and specificity of the AFB and WLB in detecting cancer of the airway mucosa. Methods: Between September 2009 and May 2010, bronchoscope examinations using both the AFB and WLB were performed on 136 patients, 95 men and 41 women with a median age of 61.5 years (ranged from 25 to 84 years). There were 46 lesions located in the central airway, 84 in the peripheral lung parenchyma, and 6 in the mediastinal region. All patients received local and general anesthesia and were subsequently examined with the WLB and AFB in tandem. All procedures were completed safely. Abnormal visual findings were recorded, and biopsies of the affected regions were collected for pathologic examination. Results: Of 241 regions sampled for biopsy, 76 sites contained malignant lesions, whereas 165 sites contained benign lesions. The AFB detected 72 of the 76 malignant lesions, but the WLB detected only 50. The sensitivities of the AFB and WLB were 94.7% and 65.8%, respectively, and the specificities were 57.0% and 83.6%, respectively. The negative predictive values of the AFB and WLB were 95.9% and 84.1%, respectively. Conclusions: The AFB is more sensitive than the WLB in detecting cancerous lesions in the mucosa, and is an effective airway examination.展开更多
Background:Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy.NSCLC is a heterogeneous group of diseases that...Background:Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy.NSCLC is a heterogeneous group of diseases that differs in cytology and includes adenocarcinoma,squamous cell carcinoma,bronchioloalveolar carcinoma,and poorly differentiated carcinoma.Usually,NSCLC,in contrast to SCLC,spreads locally,and the doubling time of squamous cell carcinoma is 133 days which classifies it as a relatively slow-growing tumor.Case presentation:We present the case of a 72-year-old male,recently diagnosed with squamous cell carcinoma in the right upper lobe along with secondary deposits.Few days after diagnosis,the patient had severe respiratory distress.This endobronchial tumor has increased significantly in size upon bronchoscopic visualization causing a complete obstruction of his right main bronchus and hypoxemic respiratory failure requiring intubation.Conclusion:To our knowledge,there are few reported cases where lung adenocarcinoma progressed rapidly over days.Squamous cell carcinoma usually takes 3 to 6 months to double in size,but in our case,the progression was very fast.In the last decade,it was confirmed that the doubling time of a tumor is an independent factor in the prognosis of lung cancer patients.On the other hand,further studies are needed to identify genes associated with rapid progression and a worse prognosis for lung squamous cell carcinoma.Hence,this aggressive tumor is a“rapid killer.”展开更多
目的采用Meta分析方法评价普通荧光支气管镜联合自发性荧光支气管镜在肺癌早期诊断中的价值,为临床应用提供依据。方法检索PubMed、ISI Web of Knowledge、Chest、Cochrane等数据库,检索时间为1990～2010年,收集普通荧光支气管镜联合自...目的采用Meta分析方法评价普通荧光支气管镜联合自发性荧光支气管镜在肺癌早期诊断中的价值,为临床应用提供依据。方法检索PubMed、ISI Web of Knowledge、Chest、Cochrane等数据库,检索时间为1990～2010年,收集普通荧光支气管镜联合自发性荧光支气管镜对肺癌早期诊断的相关文献;按纳入与排除标准筛选文献并对纳入文献进行质量评价;采用MetaDisc1.4软件对数据进行异质性分析,计算汇总敏感度、特异度、汇总似然比及汇总受试者工作特征曲线(SROC曲线),综合评价普通支气管镜联合自发性荧光支气管镜在肺癌早期诊断中的价值。结果共纳入10篇文献,样本量为2 157例,共获取活检标本4 804例,其中经病理证实为中重度不典型增生、原位癌及侵袭癌的标本为2 183例。异质性检验提示无阈值效应,但存在其他原因导致的异质性,按随机效应模型进行Meta分析得出汇总灵敏度为0.84(95%CI:0.81～0.86),汇总特异度为0.61(95%CI:0.60～0.63),汇总阳性似然比为2.25(95%CI:2.12～2.39),汇总阴性似然比为0.27(95%CI:0.23～0.32),SROC曲线下面积为0.839 5。亚组分析结果显示,6个使用肺成像荧光屏内镜(LIFE)系统的SROC曲线下面积为0.841 5,4个使用D-light Storz系统的SROC曲线下面积为0.884 1。结论普通荧光支气管镜联合自发性荧光支气管镜在肺癌的早期诊断中具有一定的特异性,敏感性较高,有一定的诊断价值,可作为临床较重要的参考指标。展开更多
文摘Background and Objective: The sensitivity and accuracy of white light bronchoscopy (WLB) in airway examination are low. Autofluorescence bronchoscope (AFB) can determine early lesions in bronchial mucosa more sensitively, but it has seldom performed in China. To assess the clinical value of the AFB in airway examination, we compared the sensitivity and specificity of the AFB and WLB in detecting cancer of the airway mucosa. Methods: Between September 2009 and May 2010, bronchoscope examinations using both the AFB and WLB were performed on 136 patients, 95 men and 41 women with a median age of 61.5 years (ranged from 25 to 84 years). There were 46 lesions located in the central airway, 84 in the peripheral lung parenchyma, and 6 in the mediastinal region. All patients received local and general anesthesia and were subsequently examined with the WLB and AFB in tandem. All procedures were completed safely. Abnormal visual findings were recorded, and biopsies of the affected regions were collected for pathologic examination. Results: Of 241 regions sampled for biopsy, 76 sites contained malignant lesions, whereas 165 sites contained benign lesions. The AFB detected 72 of the 76 malignant lesions, but the WLB detected only 50. The sensitivities of the AFB and WLB were 94.7% and 65.8%, respectively, and the specificities were 57.0% and 83.6%, respectively. The negative predictive values of the AFB and WLB were 95.9% and 84.1%, respectively. Conclusions: The AFB is more sensitive than the WLB in detecting cancerous lesions in the mucosa, and is an effective airway examination.
文摘Background:Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy.NSCLC is a heterogeneous group of diseases that differs in cytology and includes adenocarcinoma,squamous cell carcinoma,bronchioloalveolar carcinoma,and poorly differentiated carcinoma.Usually,NSCLC,in contrast to SCLC,spreads locally,and the doubling time of squamous cell carcinoma is 133 days which classifies it as a relatively slow-growing tumor.Case presentation:We present the case of a 72-year-old male,recently diagnosed with squamous cell carcinoma in the right upper lobe along with secondary deposits.Few days after diagnosis,the patient had severe respiratory distress.This endobronchial tumor has increased significantly in size upon bronchoscopic visualization causing a complete obstruction of his right main bronchus and hypoxemic respiratory failure requiring intubation.Conclusion:To our knowledge,there are few reported cases where lung adenocarcinoma progressed rapidly over days.Squamous cell carcinoma usually takes 3 to 6 months to double in size,but in our case,the progression was very fast.In the last decade,it was confirmed that the doubling time of a tumor is an independent factor in the prognosis of lung cancer patients.On the other hand,further studies are needed to identify genes associated with rapid progression and a worse prognosis for lung squamous cell carcinoma.Hence,this aggressive tumor is a“rapid killer.”
