Narrow-band imaging bronchoscopy improves assessment of tumor extent and affects therapeutic strategy for central lung cancer

Abstract

To determine the sensitivity of narrow-band imaging bronchoscopy (NBI) in the assessment of tumor extent and therapeutic strategy. A total of 196 patients with imaging abnormalities for malignancy were examined with both white light bronchoscopy (WLB) and NBI (Olympus, EVIS LUCERA). Record the tumor infiltration, image and pathological results. There were 152 male and 44 female with a mean age of 58 years. In 22 patients (13.1%), NBI revealed greater tumor extent than WLB alone. And tumor margins were >1 cm wider on NBI examination than on WLB. In 19 patients (11.3%), that finding influenced further therapeutic course, leading to greater resection level (n = 14) or avoidance of surgery (n = 5). According to univariate analysis, tumor size > 30 mm and pathological type of squamous cell carcinoma were independent predictive factors (OR 3.13, 95% CI: 1.06-9.21, P = 0.038; OR 4.68, 95% CI: 1.02-21.58, P = 0.048). The diagnostic sensitivity of NBI group was 88.2%, specificity 83.3%, positive predictive value 98.1% and false predictive value 41.7%. And the diagnostic sensitivity of WLB group was 80.3%, specificity 55.6%, positive predictive value 94.7% and false predictive value 22.2%. The combined use of NBI bronchoscopy and conventional white-light examination has greater sensitivity and specificity for assessing tumor margins. And this technique also significantly improves the assessment of central lung cancer infiltration and influences the therapeutic strategy.