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Title: Postoperative autofluorescence bronchoscopy as a method of early detection of preinvasive lesions at patients operated on for non-small cell lung cancer

Piotr Donat, Rodryg Ramlau, Łukasz Spychalski, Wojciech Dyszkiewicz, Wojciech Kasprzak, Aleksander Barinow-Wojewódzki
Polish Oncology
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Final page:
lung cancer, preinvasive lesions, autofluorescent bronchoscopy

Introduction: The risk of development of the second primary malignant lung tumor in the patients operated because of non-small cell lung cancer (NSCLC) is estimated at 1 to 3 % in the first year after the operation. Autofluorescent bronchoscopy is a sensitive method for diagnosing preinvasive lesions and early forms of cancer in the bronchial tree in the postoperative period. Aim of the study: The identification of changes pertaining to intraepithelial carcinogenesis in the patients operated for of non-small cell lung cancer as a part of control check-ups, determining the significance of autofluorescent bronchoscopy in diagnosing preinvasive lesions and finding the correlation between a histological diagnosis of a primary tumor and a risk of development of preinvasive lesion. Material and methods: The analysis was conducted on 82 patients operated because of NSCLC and rescreened endoscopically. The biopsy specimens were drawn from abnormal and suspicious tissues under both white light and autofluorescent light. During rescreening, the Lam's nine-point histological classification system was used. Results: On average 21 months after the operation for NSCLC, 88 bronchoscopic examinations, both conventional and autofluorescent ones, were performed in 82 patients. The I or II degree of postoperative advancement was found in 62 patients out of the 82 analyzed. The lesions pertaining to intraepithelial neoplasia were diagnosed in six patients (7.3%). Five lesions were diagnosed solely by means of autofluorescent bronchoscopy while one lesion was visible in both autofluorescent bronchoscopy and the conventional one. Four patients were operated because of squamous cell carcinoma. Conclusions: The examinations of the patients after the operation for NSCLC by means of autofluorescent bronchoscopy enabled to diagnose preinvasive lesions in 6 patients, which constituted 7.3% of the analyzed. The patients, who were diagnosed with squamous cell carcinoma and underwent operation, are the group that benefits most from autofluorescent bronchoscopy.