Utility of fluorescence-guided biopsy in suspected lung cancer patients with bronchial mucosal lesions

Abstract

Abstract Background: Bronchoscopy is currently the most commontechnique for lung cancer diagnosis. Patients suspected of malignancy often undergo bronchoscopic examination, and biopsy is routinely used in patients with visible bronchial lesions. However, it is difficult to differentially diagnose lung cancer in patients with bronchial mucosal lesions. Thus, this study was conducted to investigate the utility of fluorescence-guided biopsy in suspected lung cancer patients with bronchial mucosal lesions. Methods: We conducted a retrospective studyin a single screening center to assess the sensitivity and specificity of fluorescence-guided biopsy compared with white light bronchoscopy (WLB) in patients with bronchial mucosal lesions. Results: A total of 301 patients with bronchial mucosal lesions were enrolled in this study. The sensitivity for patients with fluorescence-guided biopsy was 60.3% (95% confidence interval [CI]: 53.1%-67.1%), which was higher than that of patients with WLB alone (45.2%, 95% CI: 38.2-52.4%) (P= 0.0026). Additionally, compared with the WLB group, the fluorescence -guided biopsy group was found to have a significantly higher specificity (100%, 95% CI: 95.5-100% versus 69.6%, 95% CI: 59.6-78.1%), positive predictive value (100%, 95% CI: 96.1-100% versus 74.3%, 95% CI: 65.5-81.7%) and negative predictive value (56.3%, 95% CI: 48.8-63.6% versus39.4%, 95% CI: 32.3-47.0%). Conclusion: Fluorescence-guided biopsy can serve as an important adjunct to WLB for the differential diagnosis of lung cancer in patients with bronchial mucosal lesions.