Determinants of diagnostic bronchial washing in peripheral lung cancers
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.
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: 2007-02-01
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