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Determinants of diagnostic bronchial washing in peripheral lung cancers

Authors: Lee, H. S.1; Kwon, S. Y.2; Kim, D. K.3; Yoon, H. I.2; Lee, S-M.4; Lee, J. H.2; Lee, C-T.2; Chung, H. S.3; Han, S. K.4; Shim, Y-S.4; Yim, J-J.4

Source: The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 2, February 2007 , pp. 227-232(6)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

OBJECTIVE: To establish clinical determinants affecting the diagnostic yield of bronchial washing.

SETTING: We performed bronchial washing in 241 consecutive patients with bronchoscopically invisible lung tumours. Of these, 150 patients known to have lung cancer were enrolled for the final analysis.

DESIGN: A multi-centre study.

RESULTS: Bronchial washing provided a diagnosis of lung cancer in 30 of the 150 patients (20%). Tumour size ≥3 cm (P = 0.005), the location of the tumour within 8 cm of the carina (P = 0.003), and exposed type bronchus sign of tumour (P < 0.001) were factors affecting diagnostic bronchial washing for bronchoscopically invisible lung cancers. However, multivariate logistic regression revealed that exposed type bronchus sign was the sole determinant (OR 19.22, 95%CI 4.23–87.46, P < 0.001).

CONCLUSION: Bronchial washing is a useful procedure for the diagnosis of bronchoscopically invisible lung cancers. As the tumour–bronchus relationship is the most important determinant of a diagnostic yield, the routine use of bronchial washing should be considered for tumours with exposed type bronchus sign.

Keywords: bronchial washing; bronchoscopy; bronchus sign; lung cancer

Document Type: Regular Paper

Affiliations: 1: Division of Respiratory and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; and National Cancer Center, Gyeonggi-do, Republic of Korea 2: Department of Internal Medicine and Respiratory Center, Seoul National University Bundang Hospital, Kyeonggi-do, Republic of Korea 3: Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea 4: Division of Respiratory and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Republic of Korea

Publication date: February 1, 2007

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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