Objective: To determine the sensitivity of autofluorescence bronchoscopy (AFB) in the assessment of tumor size and therapeutic strategy.
Methods: Patients with imaging suspected of malignancy were examined with both white light bronchoscopy (WLB) and AFB. The area of tumor infiltration, imaging information and pathological results were analyzed.
Results: A total of 212 patients were enrolled, including 180 male and 32 female. In 24 patients (13.2%), greater tumor volume was revealed by AFB than by WLB alone. In these patients, the median diameter of tumor was >1 cm wider on AFB examination than on WLB. Therapeutic strategy was changed in 18 patients (9.9%) after receiving AFB, including 15 patients with expanded scope of removal and 3 patients with avoidance of surgery. In the univariate analysis, the pathological type of squamous cell carcinoma and tumor invasion in two or more segments of bronchus were independent predictive factors. Diagnostic sensitivity of AFB group was 85.7%, specificity 73.3%, positive predictive value 95.1%, false predictive value 45.8%. Diagnostic sensitivity of WLB group was 72.5%, specificity 60.0%, positive predictive value 91.7%, false predictive value 26.5%.
Conclusion: Our study suggests that compared with WLB alone, autofluorescence bronchoscopy plus WLB significantly improves the diagnostic value and treatment outcome of central lung cancer.