Role of High Definition (HD) Bronchoscopy in Histological Diagnosis of Lung Cancer According to Bronchial Vascular Patterns.
Maher Shokry Wahba;
Abstract
Lung cancer is the leading cause of cancer-related mortality worldwide. Overall 5-year survival is poor at 15% with little improvement over the last twenty years. By the time patients present to clinicians, the condition is fairly advanced and, at best, only 25-30% of patients can be offered curative resection. There has been a lot of interest in screening tests for detection of early lung cancer. Screening tests using sputum cytology and chest radiograph have been used with limited success.
Bronchoscopy plays an important role in the diagnosis and staging of lung cancer. Bronchoscopic techniques for early detection of lung cancer are a promising tool as they might allow visualizing changes of early lung cancer and also permitting sampling for histological confirmation. It is important to detect bronchial carcinoma in situ (CIS) since over 40% of these can develop into invasive cancer.
Few studies have examined dysplasias in detail by conventional white light bronchoscopy, and the only descriptions are of swelling and redness at bronchial bifurcations. Recently, dysplastic lesions examined in the bronchial mucosa by white light bronchoscopy using a bronchovideoscope together with fluorescence bronchoscopy using a Light Induced Fluorescence Endoscopy (LIFE) lung system. However, it remained impossible to obtain findings other than swelling and redness at bronchial bifurcations.
Observations made in past by fluorescence bronchoscopy have revealed that pre-invasive bronchial lesions have abnormal brown or reddish brown fluorescence, which can distinguish precancerous tissues from normal bronchial tissue. Increased thickening of the bronchial epithelium, increased vessel growth and a loss of fluorophore concentration are thought to be related to the appearance of areas of abnormal fluorescence. This may explain why many observers have found inflammation in mucosa with abnormal fluorescence.
Bronchoscopy plays an important role in the diagnosis and staging of lung cancer. Bronchoscopic techniques for early detection of lung cancer are a promising tool as they might allow visualizing changes of early lung cancer and also permitting sampling for histological confirmation. It is important to detect bronchial carcinoma in situ (CIS) since over 40% of these can develop into invasive cancer.
Few studies have examined dysplasias in detail by conventional white light bronchoscopy, and the only descriptions are of swelling and redness at bronchial bifurcations. Recently, dysplastic lesions examined in the bronchial mucosa by white light bronchoscopy using a bronchovideoscope together with fluorescence bronchoscopy using a Light Induced Fluorescence Endoscopy (LIFE) lung system. However, it remained impossible to obtain findings other than swelling and redness at bronchial bifurcations.
Observations made in past by fluorescence bronchoscopy have revealed that pre-invasive bronchial lesions have abnormal brown or reddish brown fluorescence, which can distinguish precancerous tissues from normal bronchial tissue. Increased thickening of the bronchial epithelium, increased vessel growth and a loss of fluorophore concentration are thought to be related to the appearance of areas of abnormal fluorescence. This may explain why many observers have found inflammation in mucosa with abnormal fluorescence.
Other data
| Title | Role of High Definition (HD) Bronchoscopy in Histological Diagnosis of Lung Cancer According to Bronchial Vascular Patterns. | Other Titles | دور منظار الرئة عالى الوضوح فى التشخيص الخلوى لسرطان الرئة طبقاً لأنماط الأوعية الدموية فى القصبات الهوائية. | Authors | Maher Shokry Wahba | Issue Date | 2017 |
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