Yield of different bronchoscopic techniques in diagnosis of lung cancer

Abstract

Background: Lung cancer is generally diagnosed during late stage of the disease so early diagnosis of lung cancer is very important to reduce lung cancer death rate. Flexible fibreoptic bronchoscopy revolutionized early diagnosis of lung cancer as it provides sufficient cytologic and histologic specimens in form of bronchial brushings, broncho-alveolar lavage and bronchial forceps biopsy. Cytologic techniques are safe, economical, and provide quick results. They not only complement tissue biopsies in the diagnosis of lung cancer but are also comparable in yield.Methods: The present study analyzes cytology of Bronchoalveolar lavage, Bronchial Brushings and histology of bronchial biopsy in 45 patients diagnosed as lung cancer by fiber-optic bronchoscopy. Age, gender, smoking habits, various histological types of malignancies, and yield of various bronchoscopic diagnostic techniques in the diagnosis of lung cancer were evaluated.Results: Of the 45 cases with confirmed diagnosis, 37 (82.22%) were males and 8 (17.17%) were females with male to female ratio of 4.6:1. The mean age in this study group was 54.71 years. Squamous cell carcinoma was the most common primary bronchogenic tumor (62.22%) followed by adeno carcinoma (26.66%). The overall diagnostic yield of fiber-optic bronchoscopy procedures was 100% (32/32 patients) in bronchoscopically visible tumors. Bronchial biopsy was most sensitive (100%) followed by Bronchial Brushings (88%) and BAL (81.25%). However, in non-visible tumors, biopsy, brush and BAL yielded diagnostic specimens for lung cancer in 84.61%, 76.92% and 46.15% of patients respectively.Conclusions: Lung cancer is a common malignancy with male preponderance. Bronchial biopsy has a very high diagnostic yield. Cytopathological examination of bronchial brushings and broncho-alveolar lavage not only complement tissue biopsies in the diagnosis of lung cancer but have comparable diagnostic yield.