Multiple suspicious lesions detected by autofluorescence bronchoscopy predict malignant development in the bronchial mucosa in high risk patients

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2003-09, Vol.41 (3), p.295-301
• Main Authors: Pasic, Arifa, Vonk-Noordegraaf, Anton, Risse, Elle K.J., Postmus, Pieter E., Sutedja, Tom G.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Autofluorescence bronchoscopy; Biological and medical sciences; Bronchoscopy - methods; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - etiology; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - etiology; Cell Transformation, Neoplastic; Cohort Studies; Databases, Factual; Early lung cancer; Female; Fluorescence; Follow-Up Studies; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - etiology; Male; Malignant development; Medical sciences; Middle Aged; Pneumology; Precancerous Conditions - diagnosis; Predictive Value of Tests; Sensitivity and Specificity; Tumors of the respiratory system and mediastinum
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/S0169-5002(03)00191-0

Autofluorescence bronchoscopy (AFB) has been shown to be sensitive to detect preneoplastic lesions in central airways. Apart from bronchial mucosa thickness, tissue autofluorescence is also related to the biochemical properties of the target cells. Genetic studies have shown molecular abnormalities to be present in histologically normal mucosal specimens. Forty-six high-risk individuals, free of micro-invasive cancer at the initiation of the study, were included in this analysis and have been subjected to repeat bronchoscopic examinations every 4–6 months. They had previous curatively treated lung cancer ( n=18), ENT tumor ( n=11) or were at risk to acquire lung cancer primaries ( n=17). Baseline AFB is scored for each suspicious lesion, thus the total score represents the number of AFB suspicious lesions present in each individual at risk. Baseline AFB score was correlated to outcome, i.e. the development of squamous-cell cancer (SCC) in each individual. So far, 11/46 (24%) of the individuals acquired SCC. Follow up has been 12–80 months. All five individuals with ≥3 lesions (100%, 12–36 months), five of the ten (50%, 12–48 months) individuals who had two lesions and one among the 12 (8%, 36 months) individuals with one suspicious AFB lesion, developed SCC. Up till now (12–80 months), the remaining 19 individuals without any suspicious AFB lesion have not acquired SCC. The average AFB score for the group of individuals which developed SCC was significantly different ( P