Diagnostic Yield of Bronchoscopy Guided Procedures in Lung Cancer including conventional TBNA

ABSTRACT Background- Lung Cancer is the leading cause of cancer deaths around the world. Lung cancer has been the most common cancer worldwide since 1985 and is the largest contributor to new cancer diagnosis and death from cancer. Lung cancer accounts for 13.8% of all cancer diagnosis in India. Due to high prevalence of smoking behavior in rural and urban zones Lung cancer is the dominant category found in western part of Rajasthan. Since its introduction; fiberoptic bronchoscope has become an increasingly important diagnostic and therapeutic tool in respiratory diseases including lung cancer. Various diagnostic techniques like Forcep biopsy, bronchial washing and bronchial brushing, transbronchial needle aspiration cytology (TBNA) are employed during fiberoptic bronchoscopy to increase the diagnostic yield. Methods- This is a prospective study conducted during March 2011- Sept.2012 at Bronchoscopy unit of K N Chest Hospital Jodhpur, to find the role of TBNA technique during Fiberoptic bronchoscopy and was compared to other CDTs in Diagnosing Lung malignancies, included 210 patients on the basis of clinical and radiological features of malignancy. Fiberoptic Bronchoscopic abnormalities were categorized as Exophytic Endobronchial Lesions, Submucosal Lesions, Peribronchial Lesions and No abnormality. TBNA and other CDTs like Forcep Biopsy, Bronchial Brush and Bronchial Wash were performed during bronchoscopy procedure. Histopathological and cytological examinations of specimens were performed at Pathology department. The statistical analysis was done using Chi Square test. Results- In Exophytic Endobronchial Lesions, yield of TBNA, CDTs and TBNA plus CDTs were 62.60%, 79.67% and 84.55% respectively. Yield difference of all these techniques is highly significant (p0.8). In Peribronchial Lesions TBNA has significant yield i.e. 63.41% individually as compared to Forcep biopsy 26.82% and CDT 39.02% (p