Author/Editor		Zidarn, Mihaela; Debevec, Lučka; Debeljak, Andrej
Title		Diagnostična vrednost bronhialnih biopsij pri centralnem pljučnem raku
Translated title		Diagnostic value of bronchial biopsy in central lung cancer
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 9, št. 22
Publication year		2004
Volume		str. 5-10
Language		slo
Abstract		Purpose. To determine the diagnostic value of bronchial biopsy in primary lung cancer. Methods. We reviewed bronchial biopsy specimens taken from 100 patients with a suspected lung cancer in order to determine the diagnostic yield of bronchial biopsy accomplished during the first bronchoscopy. During flexible fiberoptic bronchoscopy (Olympus Tx40, forceps Olympus FB-20C-1 and FB-19C-1), specimens were taken from non-necrotic tumour margins with the patient under local anesthesia. The diagnosis of non-small cell lung carcinoma was established by cytology. Biopsy specimens from patients with small cell lung cancer, as well as all cytologically negative or diagnostically inconclusive specimens were additionally examined by histology. Results. Primary lung cancer was diagnosed in 74 of the 100 patients evaluated by bronchial biopsy. In 63 patients, the diagnosis was made by cytological analysis of biopsy specimerns obtained during the first bronchoscopy. The diagnostic yield of bronchial biopsy accomplished during the first bronchoscopy was 85%. The result was not improved by histology of cytologically negative or diagnostically inconclusive specimens. Eleven false-negative results were obtained. in three, the diagnosis was confirmed by transbronchial biopsy, in three, by transthoracic needle aspiration, in one, by bronhoscopic needle aspiration of the main carina, and in one, by repeated bronchial biopsy. Three cases were not confirmed microscopically, but were diagnosed as primary lung cancer on the basis of the clinical course. The overall diagnostic yield of bronchoscopy was 92%. In the sample of 100 patients undergoing bronchial biopsy there were no false-positive results. The negative predictive value of both cytology and histology of bronchial biopsy specimens was 70% ,for the first bronchnscopy, and 81%, for all bronchoscopies. (Abstract truncated at 2000 characters)
Summary		Namen. Namen študije je bil ugotoviti diagnostično vrednost bronhialne biopsije pri centralnih pljučnih tumorjih z retrospektivno analizo. Metode. Pregledali smo bronhialne biopsije pri 100 bolnikih, pri katerih je bil v diferencialni diagnozi postavljen sum za diagnozo centralni pljučni rak. Zanimal nas je diagnostični izplen bronhialne biopsije pri prvi bronhoskopiji. Bronhoskopije so bile opravljene v lokalni anesteziji z upogljivim bronhoskopom Olympus Tx40, s kleščicami Olympus FB-20C-lin FB-19C-I, ob robu tumorja, na mestu, kjer ni bilo nekroze. Diagnoza je bila pri bolnikih z nedrobnoceličnim rakom ugotovljena s citološkim pregledom vzorcev bronhialnih biopsij. Pri drobnoceličnem raku je bil opravljen tudi histološki pregled bioptatov. Ravno tako je bil histološki pregled opravljen pri vseh citološko negativnih in sumljivih vzorcih. Rezultati. Od 100 pregledanih bolnikov jih je imelo 74 primarnega pljučnega raka. Pri 63 (v 85%) je bila diagnoza postavljena s citološkim pregledom bronhialnega bioptata, odvzetega pri prvi bronhoskopiji. Lažno negativnih je bilo 11 izvidov. Histološki pregled negativnih vzorcev ni povečal občutljivosti preiskave. Pri 11 lažno negativnih smo pri treh bolnikih postavili diagnozo z bronhoskopsko biopsijo pljuč, pri enem z bronhoskopsko igelno biopsijo glavne karine, pri enem s ponovno bronhialno biopsijo, pri treh bolnikih je bila diagnoza postavljena na podlagi kliničnega poteka. V 92% je bila diagnoza postavljena s pomočjo bronhoskopije. Le pri treh bolnikih je bila diagnoza postavljena s pomočjo transtorakalne igelne biopsije. V vzorcu 100 bolnikov pri katerih, so bile opravljene bronhialne biopsije, ni bilo lažno pozitivnih vzorcev. Negativna napovedna vrednost citološke in histološke preiskave vzorcev, dobljenih z bronhialno biopsijo pri prvi bronhoskopiji, je 70%, negativna napovedna vrednost bronhoskopije v celoti pa 81%. (Izvleček skrajšan pri 2000 znakih)
Descriptors		LUNG NEOPLASMS BRONCHOSCOPY BIOPSY FALSE NEGATIVE REACTIONS