Utility of various bronchoscopic modalities in lung cancer diagnosis

Background: Bronchoscopy and different techniques to obtain tissue sample form the cornerstone of lung cancer diagnostics. The utility, specificity and sensitivity of various techniques are compared against each other and also in relation to the tumour type, location and morphology. Aim: To assess and compare the utility of various bronchoscopic procedures in lung malignancies. Study also compares the utility of these techniques on tumour site, morphology and cell type. Methods: One hundred and fifty six patients with suspected malignancies in whom bronchoscopy was deemed as the primary diagnostic procedure were selected. These patients underwent bronchoscopic lavage, brushings and biopsy. Samples were assessed by microbiological, cytology and histopathological analysis. Results: Bronchoscopic procedures have a high diagnostic accuracy of 81.25% in confirming lung malignancies in central tumours and also in non-accessible peripheral tumours. Bronchial brushings had the highest yield in central tumours (55.9%) and a reasonably good yield even in perpipheral tumours (40.8%). When all the modalities were compared against each other, brushings was the single most decisive technique as it alone yielded a diagnosis in a significant 33% of cases, whereas the comparative diagnosis by biopsy alone was in a minority 7.6% of cases.