Abstract
BackgroundLung cancer has a very poor prognosis and high mortality. Positive sputum for malignant and/or atypical cells warrants the need for fibreoptic bronchoscopy. White light bronchoscopy (WLB) is usually unable to detect preinvasive lesions; therefore, autofluorescence bronchoscopy (AFB) was introduced as a gold standard for detecting such lesions. The aim of this work was to investigate the role of I-scan as a screening tool for cancer in smoker patients showing positive sputum cytology.ResultsNew suspicious findings under I-scan occurred in 11 patients (36.7%). The overall sensitivity of WLB alone to diagnose malignancy is 23.3%, in contrast to an added sensitivity of 50% when I-scan was combined with white light (p value < 0.05). The specificity of I-scan could not be assessed in the absence of control cases (true negatives). No major complications or deaths occurred. Haemorrhage and bronchospasm were the commonest minor complications.ConclusionsThe addition of I-scan to the routine white light examination can increase the overall sensitivity of bronchoscopic screening in cases of sputum suspicious for malignancy if put in experienced hand. The suggested increase in procedure duration due to the combined use of I-scan and white light bronchoscopy is not associated with life-threatening complications.
Highlights
Lung cancer has a very poor prognosis and high mortality
In contrast to autofluorescence bronchoscopy (AFB), I-scan depends on the use of one light source giving full-spectrum white light followed by image enhancement on real-time basis, which is easier and more convenient [9]
Patients with any suspicious lung shadow or infiltrate on plain chest radiographs and Computed tomography (CT), in addition to those having any contraindication to bronchoscopy procedure, were excluded
Summary
Lung cancer has a very poor prognosis and high mortality. Positive sputum for malignant and/or atypical cells warrants the need for fibreoptic bronchoscopy. The aim of this work was to investigate the role of I-scan as a screening tool for cancer in smoker patients showing positive sputum cytology. Lung cancer has less than 15% 5-year survival rates with a mortality rate of more than 90% [1]. Positive sputum for malignant and/or atypical cells, especially in risk group patients, is likely an indicator for the need for fibreoptic bronchoscopy to confirm malignancy with a hope of curable resection [3]. In contrast to AFB, I-scan depends on the use of one light source giving full-spectrum white light followed by image enhancement on real-time basis, which is easier and more convenient [9]
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