Table of Contents Author Guidelines Submit a Manuscript
Diagnostic and Therapeutic Endoscopy
Volume 6 (1999), Issue 1, Pages 1-7
http://dx.doi.org/10.1155/DTE.6.1

Fluorescence Bronchoscopic Surveillance in Patients With a History of Non-Small Cell Lung Cancer

1Department of Surgery, Section of Thoracic Surgery, University of Pittsburgh Medical Center, C800, 200 Lothrop Street, Pittsburgh 15213, PA, USA
2Department of Pathology, Section of Thoracic Surgery, University of Pittsburgh Medical Center, C800, 200 Lothrop Street, Pittsburgh 15213, PA, USA

Received 29 October 1998; Revised 29 June 1999; Accepted 6 July 1999

Copyright © 1999 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background Second lung primaries occur at a rate of 2% per patient per year after curative resection for non-small cell lung carcinoma (NSCLC). The aim of this study was to evaluate the role of fluorescence bronchoscopy using the Xillix® LIFE-Lung Fluorescent Endoscopy SystemTM (LIFE-Lung system) in the surveillance of patients for second NSCLC primaries after resection or curative photodynamic therapy (PDT).

Methods NSCLC patients who were disease-free following resection or endobronchial PDT were identified and recruited to participate in a LIFE bronchoscopy surveillance program. All suspicious areas were biopsied; areas of apparent normal mucosa served as negative controls. Biopsy specimens were reviewed by a single pulmonary pathologist.

Results Thirty-six patients underwent 53 surveillance LIFE bronchoscopies and 6/112 biopsies revealed intraepithelial neoplasia (IEN) or invasive carcinoma in 6/36 (17%) of patients. The overall relative sensitivity of LIFE versus conventional bronchoscopy was 165% with a negative predictive value of 0.96, for the post-resection subset of patients these values increased to 200% and 0.97, respectively.

Conclusions Surveillance LIFE bronchoscopy identified intraepithelial or invasive lesions in 17% of patients previously thought to be disease-free. These data support future multicenter trials on fluorescence bronchoscopic surveillance of NSCLC patients after curative surgical resection or PDT.