Abstract

The aim of the present study was to investigate the relationship between endobronchial appearance and the productivity of broncoscopic techniques in subjects with lung cancer diagnosed by broncoscopic methods. Three hundred and thirty two subjects with lung cancer diagnosed between 2000-2003 were included in the present study. Forceps biopsy alone was the most valuable diagnostic method with 90.3% diagnostic success rate in compared with other methods applied alone in all cases. Forceps biopsy plus transbronchial fine needle aspiration (TBFNA) offered 97.6% diagnostic success rate. In direct tumoral findings such as tumoral infiltration and vegetan tumor, forceps biopsy offered 93.2% and 97.7% positive result, respectively. The positive diagnostic rate was 80% in indirect tumoral group. The results was statistically significant (p<0.05). No relationship was observed between broncoscopic appearance and TBFNA or brush biopsy or bronchial aspiration (p= 0.97, p= 0.79, p= 0.12, respectively). Forceps biopsy plus bronchial aspiration offered up to 97.6% diagnostic success rate in subjects with vegetan tumoral finding. In subjects with tumoral infiltration finding, diagnostic success rate was 97.1% with the usage of combination of forceps biopsy and transbronchial fine needle aspiration techniques. With the addition of bronchial aspiration to combination of forceps biopsy and transbronchial fine needle aspiration, diagnostic success rate reached up to 98.4%. In subjects with indirect tumoral findinds, forceps biopsy plus transbronchial fine needle aspiration offered up to 96.7% diagnostic success rate. In the light of these findings and the literature, we concluded that; 1-Each biopsy technique has advantages and disadvantages peculiar to itself; thus, as it is possible, different biopsy techniques should be used together. 2-Bronchial aspiration is easy, cheap and noninvasive method; thus, it should be undoubtedly added to combination. 3-High diagnostic productivity can be obtained with forceps biopsy plus brush biopsy in subjects with direct tumoral findings such as vegetan tumor or tumoral infiltration; however, forceps biopsy plus TBFNA offers high diagnostic productivity in subjects with indirect tumoral findings.