Bronchoskopická metoda narrow band imaging v diagnostice plicních nádorů
| Title in English | Narrow band imaging - A bronchoscopy method for diagnosing lung cancer |
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| Authors | |
| Year of publication | 2018 |
| Type | Article in Periodical |
| Magazine / Source | Studia pneumologica et phthiseologica |
| MU Faculty or unit | |
| Citation | |
| Keywords | Bronchoscopy; Lung cancer; Narrow band imaging |
| Description | A total of 500 patients underwent bronchoscopy examinations using the narrow band imaging (NBI) mode and, subsequently, the white light (WL) mode. Examinations were indicated by abnormal CT or X-ray findings (n = 420; 84.0 %), hemoptysis (n = 33; 6.6 %), follow-up after chemotherapy and radiotherapy (n = 21; 4.2 %), follow-up after neoadjuvant chemotherapy (n = 14; 2.8 %) and follow-up after surgery for lung cancer (n = 12; 2.4 %). Pathological findings in the NBI mode were classified into 4 groups: (1) a pattern of dotted vessels with a tortuous course, (2) a pattern of abrupt-ending vessels with disturbed architecture, (3) an avascular pattern typical for necrosis and (4) a pattern of complex vascular networks. Pathological findings in the WL mode were assessed according to the generally valid criteria for pathological malignant processes. From each site of pathological findings in both modes, a biopsy was obtained for histological examination. Histological examination results were evaluated with respect to relative sensitivity and relative rates of false-positive results as compared with WL. Statistical significance was determined using McNemar's test. Abnormal bronchoscopy findings were recorded in a total of 382 patients (76.4 %). Positive findings in both the NMI and WL modes were detected in 331 patients (66.2 %). Discordant NBI-/WL+ and NBI+/WL-findings were observed in 29 cases (5.8 %) and 22 cases (4.4 %), respectively. Relative sensitivity and relative rates of false-positive results of NBI as compared with WL were analyzed for histological findings of malignancies of severe dysplasia. The relative sensitivity of NBI vs WL was 1.06 (p < 0.01; sensitivity of NBI is significantly higher). The relative rate of false-positive results of NBI vs WL was 0.91 (p = 0.01; the rate of false-positive results of NBI is significantly lower). The analysis snowed statistically significantly improved accuracy of examination as compared with WL. NBI examination is good at distinguishing a necrotic avascular area in a tumor from viable tissue, resulting in more accurate determination of the most suitable site for biopsy. |