Original Research Paper
Compartive Analysis Between Fibro-optic Bronchoscopic Cytohistological Lung Biopsy Technique And Other Less Invasive Fibro-optic Bronchoscopic Techniques In Diagnosis Of Lung Cancer
Dr. Hager Mohammed Mahmoud Nousseir, Prof. Ibrahim Mahmoud Shaalan, Dr. Haytham Abdullah Abd Elmaksoud
Background: The use of cytological methods in the diagnosis of malignant lesions of the respiratory tract has been generally acclaimed as one of its most successful applications. Flexible fibro-optic bronchoscopy revolutionized respiratory cytology, as bronchial brushings, bronchial wash, broncho-alveolar lavage and bronchial forceps biopsy became more easy, accessible and popular, shifting the emphasis from diagnosis of advanced malignancy in inoperable patients to the use of cytology as a first line diagnostic and management tool. Respiratory tract cytology is well established throughout the world as a diagnostic procedure in the evaluation of patient with suspected lung malignancy.Aim of the study:- To determine which one has high specificity in final diagnosis of lung cancer, Is it bronchoscopic forceps biopsy(FB) or other less invasive bronchoscopic techniques as bronchial brush(BB), bronchial wash(BW) or broncho-alveolar lavage(BAL).- To determine and confirmed if that the combination of various bronchoscopic cytohistological techniques complements each other and enhances the diagnostic efficacy of neoplastic lung disease (lung cancer) or not i.e. bronchoscopic forceps biopsy(FB) with bronchial brushing (BB), bronchial wash(BW) or/and the broncho-alveolar lavage (BAL).Materials and Methods: A prospective study was conducted on 20 patients divided in two groups who underwent fibro-optic bronchoscopy during the period from August 2021 to June 2022 at the Interventional Bronchoscopy Unit of Chest Department, Faculty Of Medicine, Al-Azhar University Hospital and Assiut University Hospital. Patients were classified into 2 groups; group (I): consisted of 14 cases of Malignant lung cancer, and group (II): consisted of 6 cases of Benign lung cancer.Results: This study revealed that the bronchoscopic forceps biopsy is the most bronchoscopic technique which preferred in diagnosis of lung cancer and in the identification of its type. This point reported from this study when we make comparison according to the accuracy ratio of fibro-optic bronchoscope lung techniques in diagnosis of lung cancer and identification of its type among the studied patients and also this study showed that the accuracy ratio of fibro-optic bronchoscopic forceps biopsy in the diagnosis of lung cancer among all the studied patients in this study was 23.5% for benign lung cancer and 76.5% for malignant lung cancer. Also this study revealed that the comparison of accuracy ratio of fibro-optic bronchoscope lung techniques in diagnosis of lung cancer among the studied patients showed that the bronchoscopic forceps biopsy is the most one preferred (85%), then the bronchial brush (20%), after that the bronchial wash (15%), and in the last and the most one not useful in diagnosis of lung cancer was bronco-alveolar lavage (0%), but the combination of all of these techniques with each Conclusion: The Bronchoscopic Forceps Biopsy (FB) technique is the most technique from all fibro-optic bronchoscopic lung techniques which has high specificity in final diagnosis of lung cancer and determines its type either benign lung cancer or malignant lung cancer than other less invasive bronchoscopic techniques as bronchial brush(BB), bronchial wash(BW) or broncho-alveolar lavage(BAL); but its accuracy percent in identification the certain final diagnosis of lung cancer come in second place after the Surgical Open Lung Biopsy (OLB) technique.The combination of various bronchoscopic lung cytohistological techniques complements each other and enhances the diagnostic efficacy of lung cancer than each technique alone.
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