Abstract
Recently several endoscopic fluorescence detection systems have been developed. In some of them, laser light was used for the excitation of autofluorescence, and sophisticated techniques were also necessary to amplify the fluorescence signal as well. The result of fluorescence diagnosis using a simple system with a conventional Xenon lamp excitation and an image intensifier is reported. The respective results of sensitivity and positive predictive values of cancer plus dysplasia were 66%, and 62% by standard bronchoscopy and 92% and 88% by the newly developed autofluorescence system. In this paper, developed endoscope for detection of tissue/mucosal autofluorescence without the application of any photosensitizing agents or use of any lasers is evaluated.
Highlights
The number of early stage lung cancer has increased in recent years in Japan, mainly due to the common use of sputum cytology for high risk patients or symptomatic patients in Japan
In the multistep carcinogenesis theory, dysplasia has been considered as one of the precancerous status, which we have proved by animal experiments and immunohistochemical studies [12,13]
The subjects were classified into three categories; cases with lung cancer, 42 cases (58%), abnormal sputum cytology findings, 16 cases (22%) and smokers with recurrent symptoms, 14 cases (19%), respectively
Summary
The number of early stage lung cancer has increased in recent years in Japan, mainly due to the common use of sputum cytology for high risk patients or symptomatic patients in Japan. Since central type early stage lung cancer shows no abnormality on chest X-ray or even on helical CT, endoscopy is the only method to detect these lesions. When localization fails in cases with positive sputum cytology, blind brushing or washing cytology examination of segmental or subsegmental bronchi is commonly performed [6]. Photodynamic diagnosis is another approach to detect these lesions [7] but photosensitizer cannot be used routinely. To overcome this problem, Lam and Palcic created a fluorescence detection system [8,9,10,11]. The principle of this system is based on the phenomenon that the intensity of autofluorescence of tumor is different from that of normal tissue illuminated by light with
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