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Vol. 14, Art. 4 (pp. 40-51)    |    2013       

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Morphologic and endoscopic parallels in early central lung cancer diagnostics

Zhelbunova E.A.

N.N. Petrov Research Institute of Oncology

Brief summary

This article summarizes the experience of application of the new combined endoscopic method for early central lung cancer diagnosis. Method is based on the qualitative and quantitative assessment of the bronchoscopic images obtained in the autofluorescence and white light modes combined with measurement of reflected and autofluorescence spectra in 167 patients. AUC of receiver operating characteristic (ROC) curves showed good discrimination with maximum sensitivity - 94.74% (95% CI: 80,9% -99%) and specificity - 79.95% (95% CI: 75,8% -83,6%). The use of spectral coefficients can improve the specificity of the method and reduce the number of unnecessary biopsies and minimize trauma during the procedure. Immunohistochemistry showed significant differences in expression levels of several antibodies - СD31 и CD34 (р<0,05), EGFR (р<0,05), Ki-67 (р<0,001) - and p53 (p <0.001 ) in different stages of dysplasia.


Key words

central lung cancer, autofluorescence bronchoscopy, spectrometry, ROC curves, immunohistochemistry.

Reference list

1. Davidov M.I., Volkov S.M., Polockii B.E. Sovershenstvovanie hiryrgicheskogo lecheniya bolnih nemelkokletochnim rakom lyogkogo // Ros. onkol. jyrn. - 2001. – № 5. – S. 14 - 17


2. Merabishvili V.M., Sherbyk U.A. Onkologicheskaya slyjba v Sankt-Peterbyrge i raionah goroda v 2008 gody (zabolevaemost, smertnost, vijivaemost). Ejegodnik Popylyacionnogo rakovogo registra // SPb. - 2009. – 240 s. ISBN 978-5-91258-113-7


3. Chernehovskaya N.E. Sovremennie tehnologii v endoskopii. – M.: Rossiiskaya medicinskaya akademiya postdiplomnogo obrazovaniya, 2004. – 136 s.


4. Chissov V.I., Starinskii V.V., Petrova G.V. Zlokachestvennie novoobrazovaniya v Rossii v 2008 gody (zabolevaemost i smertnost) // M.: FGY «MNIOI im. P.A. Gercena Rosmedtehnologii», 2010.− 256 s.: il. ISBN 5-85502-024-H


5. Banerjee A.K., Rabbitts P.H., George J. Lung cancer. Fluorescence bronchoscopy: clinical dilemmas and research opportunities // Thorax. – 2003. - 58(3). – R. 266-271.


6. Fawzy Y.S., Zeng H. Determination of scattering volume fraction and particle size distribution in the superficial layer of a turbid medium by using diffuse reflectance spectroscopy // Appl. Opt. – 2006. - 1;45(16). – R. 3902-3912.


7. George P., Banerjee A.K., Read C.A. et al. Surveillance for the detection of early lung cancer in patients with bronchial dysplasia // Thorax. 2007. - Jan; 62 (1). – R. 43-50.


8. Gilbert S., Luketich J.D., Christie N.A. Fluorescent bronchoscopy // Thorac. Surg. Clin. – 2004. - Feb; 14 (1). – R. 71-77.


9. Häussinger K., Becker H., Stanzel F., Kreuzer A. et al. Autofluorescence bronchoscopy with white light bronchoscopy compared with white light bronchoscopy alone for the detection of precancerous lesions: a European randomised controlled multicentre trial // Thorax. – 2005. - Jun; 60 (6). P. 496-503.


10. Hirsch F.R., Prindiville S.A., Miller Y.E. et al. Fluorescence versus white-light bronchoscopy for detection of preneoplastic lesions: a randomized study // J. Natl. Cancer Inst. – 2001. – 93. – R. 1385–1391.


11. Kennedy T.C., Miller Y., Prindiville S. Screening for lung cancer revisited and the role of sputum cytology and fluorescence bronchoscopy in a high-risk group // Chest. - 2000 Apr; 117 (4 Suppl. 1). – R. 72S-79S.


12. Lam S., MacAulay C., leRiche J.C., Palcic B. Detection and localization of early lung cancer by fluorescence bronchoscopy // Cancer. – 2000. – Dec. 1;89 (11 Suppl). – R. 2468- 2473.