Observational cross-sectional study of 5279 bronchoscopy results for the practical effectiveness of various biopsy techniques in the diagnosis of lung diseases with particular emphasis on lung cancer

Abstract

IntroductionBronchoscopy is the main method in the diagnosis of various lung diseases. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the most modern bronchoscopic technique useful in diagnosis and staging of lung cancer (LC).ObjectiveThe aim of the study was to assess the yield of bronchoscopy in patients with suspected various respiratory diseases including LC. In particular, we examined the efficiency of different biopsy techniques in the diagnosis of LC in correlation with its localisation and pathomorphological type.Patients and methodsThe results of pathomorphological examinations from 5279 bronchoscopies performed in 2016–2018 were analysed. The material was collected with EBUS-TBNA, endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endobronchial forceps biopsy. Clinical and demographic factors were analysed using the Fisher χ2 test.Results5279 patients were diagnosed due to various respiratory symptoms. LC was confirmed in 36.42% of patients. 40.81% of patients had no definitive pathomorphological diagnosis. Among patients with LC, the most frequent diagnosis was non-small cell LC: squamous cell lung cancer (SCC)—32.07% and adenocarcinoma (AC)—30.61%, then small cell LC—25.83% and not otherwise specified non-small cell lung cancer (NSCLC-NOS)—11.49%. Diagnosis of SCC was obtained significantly more often (χ2=43.143, p<0.000001) by forceps biopsy (41.09%) than by EBUS-TBNA/EUS-FNA (26.62%). On the contrary, diagnosis of AC or NSCLC-NOS was significantly more often (χ2=20.394, p<0.000007, and χ2=3.902, p<0.05, respectively) observed in EBUS-TBNA/EUS-FNA (34.31% and 12.6%) than in endobronchial biopsies (24.52% and 9.64%).ConclusionsThe use of bronchoscopy in the diagnosis of various lung diseases is vital but also has many limitations. Effectiveness of EBUS-TBNA and endobronchial forceps biopsy in the diagnosis of lung cancer is strongly affected by tumour localisation and type of cancer.

Pathological Characteristics of Fiberoptic Bronchoscopy Procedure in Ulin General Hospital, Banjarmasin

“…Błach, et al (2021) revealed that from 5,279 patients diagnosed due to various respiratory symptoms, lung cancer was confirmed in 36.42% of patients who performed bronchoscopy. 10 Based on demographic characteristics in this study, 79.7% of patients were males, and 20.3% were females, with male to female ratio of 4:1. Men also have a slightly higher positivity rate for pulmonary malignancy than women.…”

“…11 Błach, et al (2021) also found that more men than women had lung cancer for a positive result of a bronchoscopy procedure. 10 A global cancer statistic from 2020 also revealed that the incidence of lung cancer was higher among men (14.3%) than women. The same was discovered in the mortality rate, with men (21.5%) outnumbering women (13.7%).…”

Residential Radon Exposure in Patients with Advanced Lung Cancer in Lublin Region, Poland

“…The majority of the analyzed group were patients over 65 years of age ( n = 63; 61.8%), younger patients accounted for 38.2% of the study group. The division into individual histopathological types was also performed—the study group reflects the distribution of histological types of lung cancer in the Polish population [ 20 ].…”

Clinical Application Perspectives of Lung Cancers 3D Tumor Microenvironment Models for In Vitro Cultures

“…Herein, cancer cells can be obtained from patient biopsies and collected for diagnostic research. Both the quality of the sample and its qualitative and quantitative content depend on the bronchoscopic method [93].…”