Fluorescence Bronchoscopy in the Early Detection of Premalignant and Malignant Lesions(Diagnosis and Treatment of Early Stage Central Type Lung Cancer)(The 23rd Annual Congress of the Japan Society for Bronchology)

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概要

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• The early detection of premalignant and malignant lesions in the endobronchial tree is crucial to survival in lung cancer patients. Autofluorescence bronchoscopy, e.g., the LIFE system has been developed for these patients and is now applied clinically. Many investigators in the world have demonstrated the effectiveness of this system for the early detection of endobronchial malignancies. Recently, a system of autofluorescence endoscopy(SAFE-1000, Asahi Pentax Co.Tokyo Japan)has been developed. This system is equipped with a conventional xenon lamp with a special bandpass filter as an excitation light source instead of laser light. The objective of this study was to judge if this simple fluorescence endoscopy system could be as useful as the LIFE system in detecting premalignant and malignant lesions of the bronchial tree. A total of 108 cases were studied and 234 sites were biopsied. The subjects were classified into three categories: cases with lung cancer(56 cases), abnormal sputum findings(32 cases), and smokers with current symptoms(20 cases). Bronchial biopsies were performed at the area of abnormal findings discovered by conventional bronchoscopy(CB)or SAFE-1000, and specimens were investigated histopathologically. The respective results of sensitivity for cancer plus dysplasia and dysplasia were 74% and 64% by CB and 89% and 85% by SAFE-1000. Positive predictive value(P.P.V.)was 64%(CB)and 70%(SAFE-1000). This data showed almost the same results obtained using the LIFE system by our group(sensitivity: 95% for cancer plus dysplasia, 90% for dysplasia, P.P.V.: 73%). Sensitivity for dysplasia increased in the fluorescence bronchoscopy compared with CB. The SAFE-1000 was developed for detection of mucosal autofluorescence without the application of any photosensitizers or use of any lasers was evaluated in this study. The result suggests the possibility of autofluorescence diagnosis of subtle bronchial lesions with this simple device.

• 2000-12-25

著者

• KATO Harubumi

  Department of Surgery I, Tokyo Medical College

• Ikeda Norihiko

  Department of Surgery, Tokyo Medical University

• Kato Harubumi

  Department Of Gynecology National Hospital Organization Hokkaido Cancer Center

• Ohira T

  Department Of Thoracic Surgery Tokyo Medical University

• Ikeda Norihiko

  Department Of Applied Chemistry Faculty Of Engineering Okayama University

• FURUKAWA Kinya

  Department of Chest Surgery, Tokyo Medical University

• Furukawa Kinya

  Department Of Surgery Tokyo Medical University

• Furukawa Kinya

  Department Of Chest Surgery Tokyo Medical University

• Furukawa Kinya

  Department Of Chest Surgery Tokyo Medical University Kasumigaura Hospital

• KONAKA CHIMORI

  Department of Surgery, Tokyo Medical College Hospital

• OKUNAKA Tetsuya

  Department of Surgery, Tokyo Medical University

• Konaka Chimori

  Department Of Surgery Tokyo Medical College Hospital

• Ikeda Norihiko

  Department Of Thoracic Surgery International University Of Health And Welfare

• Okunaka Tetsuya

  Department Of Thoracic Surgery Tokyo Medical University

• Ohira Tatsuo

  東京医科大学 胸部外科

• Kakihana Masatoshi

  Department of Surgery, Tokyo Medical University

• Shimatani Hideaki

  Department of Surgery, Tokyo Medical University

• Kawata Norihiko

  Department of Surgery, Tokyo Medical University

• Kato Harubumi

  Department Of Thoracic Surgery Tokyo Medical University

• Kato Harubumi

  First Department Of Internal Medicine Tokyo Medical University

• Shimatani Hideaki

  Department Of Surgery Tokyo Medical University

• Kakihana Masatoshi

  Department Of Surgery Tokyo Medical University

• Kawata Norihiko

  Department Of Surgery Tokyo Medical University

• Okunaka Tetsuya

  Department Of Surgery Tokyo Medical College

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