The application of autofluorescence bronchoscopy in guiding surgical resection range for lung cancer

Abstract

To explore the value of autofluorescence bronchoscopy in guiding surgical resection range for central lung cancer. A total of 213 patients with lung cancer were evaluated by both light bronchoscopy (WLB) and autofluorescence bronchoscopy (AFB) by BF-F260 (Olympus, Japan) before surgery from Mar. 2012 to Feb. 2013. The number of positive cases under each mode, clinical stage, surgical resection range and surgical options were evaluated to explore diagnostic value of WLB and AFB. Of the 213 cases, surgical margins were negative in 198 cases, while the remaining 15 cases were found to be inoperable. A total of 1 146 biopsies from different sites including neoplasm and bronchial mucosa were evaluated for tumor involvement by pathology. On average, biopsy was performed 5.0 ± 1.2 times for each patient. The sensitivity of the WLB group and the AFB group was 65. 2% (214/662) and 81.2% (237/484), and the specificity was 74.8% (214/662) and 54.7% (237/484), respectively, the difference being statistically significant (χ2 = 19.747, P < 0.05). Bronchial mucosal invasion was found by fluorescence bronchoscopy and the surgical procedures were changed in 27 case: from lobectomy to bilobectomy and pneumonectomy in 10, from lobectomy to inoperable in 2, from lobectomy to interlobar ridge plasty( sleeve resection) in 8, from pneumonectomy to inoperable in 3, and from pneumonectomy to carina plasty in 4 cases. In all the 213 patients, 214 pathological positive sites were found in the WLB group and 237 in the AFB group. The difference being statistically significant (χ2 = 32.439, P < 0.05). Autofluorescence bronchoscopy showed a high sensitivity for lung cancer, and was helpful to guide surgical resection range and reduce postoperative recurrence rate.