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A prospective comparison of fiberoptic transbronchial needle aspiration and bronchial biopsy for bronchoscopically visible lung carcinoma.

Publication ,  Journal Article
Govert, JA; Dodd, LG; Kussin, PS; Samuelson, WM
Published in: Cancer
June 25, 1999

BACKGROUND: Fiberoptic bronchoscopy is the most common modality used to diagnose endobronchial carcinoma. The authors prospectively compared the sensitivity of endobronchial needle aspiration (EBNA) and immediate cytologic assessment with bronchial biopsy and bronchial washing in the diagnosis of endobronchial malignancy. METHODS: A prospective trial comparing the sensitivity of EBNA, bronchial biopsy, and bronchial washings during fiberoptic bronchoscopy for endobronchially visible lung tumor was conducted. The authors enrolled 65 consecutive patients with endobronchial abnormalities identified during bronchoscopy. All patients in the study underwent fiberoptic bronchoscopy that included EBNA, bronchial biopsy, and bronchial wash. The sensitivities of the individual techniques were compared. The sensitivities of bronchoscopy were also prospectively compared when multiple sampling techniques were employed. RESULTS: Malignancy was present in 57 of 65 study patients. Cancer was diagnosed in 47 patients by EBNA, 42 patients by bronchial biopsy, and 36 patients by bronchial washing. The sensitivity of a strategy employing bronchial biopsy and bronchial washings was 0.82 (95% CI, 0.70-0.90). The addition of EBNA to bronchial biopsy and bronchial washings significantly increased the sensitivity to 0.95 (95% CI, 0.85-0.98; McNemar P = 0.02). Subset analysis revealed that this strategy was especially useful in cases in which lesions were submucosal or causing extrinsic compression. CONCLUSIONS: There is a modest increase in the sensitivity of fiberoptic bronchoscopy in diagnosing endobronchial cancer with the addition of EBNA to bronchial biopsy and bronchial washings, especially for patients with submucosal abnormalities. Collection of EBNA, followed by biopsy and washings only if immediate interpretation of EBNA is negative or inadequate, may be the most effective bronchoscopy strategy for evaluating visible endobronchial abnormalities.

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Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

June 25, 1999

Volume

87

Issue

3

Start / End Page

129 / 134

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Prospective Studies
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Fiber Optic Technology
  • Female
  • Diagnosis, Differential
 

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Govert, J. A., Dodd, L. G., Kussin, P. S., & Samuelson, W. M. (1999). A prospective comparison of fiberoptic transbronchial needle aspiration and bronchial biopsy for bronchoscopically visible lung carcinoma. Cancer, 87(3), 129–134. https://doi.org/10.1002/(sici)1097-0142(19990625)87:3<129::aid-cncr5>3.0.co;2-g
Govert, J. A., L. G. Dodd, P. S. Kussin, and W. M. Samuelson. “A prospective comparison of fiberoptic transbronchial needle aspiration and bronchial biopsy for bronchoscopically visible lung carcinoma.Cancer 87, no. 3 (June 25, 1999): 129–34. https://doi.org/10.1002/(sici)1097-0142(19990625)87:3<129::aid-cncr5>3.0.co;2-g.
Govert, J. A., et al. “A prospective comparison of fiberoptic transbronchial needle aspiration and bronchial biopsy for bronchoscopically visible lung carcinoma.Cancer, vol. 87, no. 3, June 1999, pp. 129–34. Pubmed, doi:10.1002/(sici)1097-0142(19990625)87:3<129::aid-cncr5>3.0.co;2-g.
Journal cover image

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

June 25, 1999

Volume

87

Issue

3

Start / End Page

129 / 134

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Prospective Studies
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Fiber Optic Technology
  • Female
  • Diagnosis, Differential