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Hae-Seong Nam
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EP1.05 - Interventional Diagnostics/Pulmonology (ID 195)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Interventional Diagnostics/Pulmonology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.05-05 - The Optimal Sequence of Bronchial Washing and Brushing for Diagnosis of Non-Visible Lung Cancer During Non-Guided Bronchoscopy (Now Available) (ID 2311)
08:00 - 18:00 | Presenting Author(s): Hae-Seong Nam
- Abstract
Background
The optimum sequence of obtaining bronchial washing and brushing samples in lung cancer patients with non-visible tumor during conventional bronchoscope is uncertain. Recent advanced diagnostic bronchoscopy use only is feasible in a few institutions and can be expensive. The aim of the study was to investigate the diagnostic yield of washing performed after brushing in patients with non-visible tumor during non-guided flexible bronchoscopy (FB).
Method
We performed a retrospective review of prospectively collected data of suspected lung cancer patients who were performed washing after brushing in non-visible tumor during non-guided FB from 2010 to 2015. Total 166 patients with histologically confirmed primary lung cancer were enrolled in the study.
Result
The overall diagnostic rate was 52.4 %, and the diagnostic yield of bronchial brushing and washing were 37.3 % and 46.4 %, respectively. We compared the diagnostic yield of brushing with washing using McMemar’s test. Washing had a better diagnostic yield, 46.4 % (77/166) vs. 37.3 % (62/166) (p=0.017, kappa index=0.570). Comparison of intra-individual agreements between the positive cytology of brushing or washing and the final pathologic diagnosis were a concordance rate of 89.6 % and 90.3 %, with a kappa value of 0.791 (p<0.001) and 0.801 (p<0.001), respectively. The presence of a bronchus sign, tumor size, and higher standardized uptake value on positron emission tomography scan were predictors of a higher diagnostic yield.
Conclusion
In institutions where advanced diagnostic bronchoscopy is unavailable, the sequence of washing after brushing in the diagnosis of non-visible lung cancer during non-guided FB may help improving the diagnostic yield.