The Role of Endoscopic Techniques, Laser-Induced Fluorescence Endoscopy, and Endobronchial Ultrasonography in Choice of Appropriate Therapy for Bronchial Cancer

摘要

Laser-induced fluorescence endoscopy (LIFE) is useful in detecting precancerous lesions, and endobronchial ultrasonography (EBUS) is useful in the determination of the depth of tumor invasion into the bronchial wall. We conducted a clinical trial to determine the efficacy of assessment with a combination of LIFE and EBUS in patients with intraluminal lung cancer. We performed conventional white light bronchos-copy (WLB) followed by LIFE in 54 patients, and 67 samples from sites of suspected lesions were taken for biopsy. If an endobronchial tumor was detected, EBUS was performed. We could detect 29 lesions (metaplasia, 17; moderate dysplasia, 1; carcinoma in situ, 1; invasive carcinoma, 10) with WLB and LIFE; specifically, 12 lesions were detected when LIFE was used in addition to WLB (metaplasia, 9; moderate dysplasia, 1; carcinoma in situ, 1; invasive carcinoma, 1). Six patients were selected for EBUS to be evaluated for the depth of tumor invasion. Two patients with early cancer lesions, which were restricted within the mucosa and submucosa but not outside the cartilage, were considered candidates for photodynamic therapy, 3 patients with invasive cancer were candidates for surgery, and 1 patient for chemoradiotherapy. These patients were treated successfully. The assessment of an endobronchial tumor with the combination of LIFE and EBUS proved to be useful in decision making for the type of therapy.