Diagnostic Performance of Bronchoscopic Sampling Techniques in Suspected Bronchial Carcinoma
Keywords:
Bronchscopy, Carcinoma, Endobronchial Biopsy, Bronchoalveolar LavageAbstract
Background: Lung cancer is the top cause of cancer deaths worldwide. Delayed diagnosis worsens outcomes. Flexible bronchoscopy is a key tool with several sampling techniques. Assessing their effectiveness helps improve early, accurate detection. Objective: To study the yield of malignant or suspicious cells from bronchoalveolar lavage (BAL), endobronchial biopsy (BX), and endobronchial brushing (BR) specimens obtained at bronchoscopy. Methodology: A prospective cross-sectional study was conducted on 142 patients suspected of having bronchial carcinoma. All patients underwent flexible bronchoscopy (a procedure using a thin, flexible tube to inspect the airways) with bronchoalveolar lavage (BAL: washing fluid through the airways). When feasible, endobronchial biopsy (BX: sampling of tissue from inside the bronchial tubes) and brushing (BR: collecting cells with a small brush) were also performed. Samples were examined for cytology (the study of cells) and histopathology (the study of tissue structure and disease). The diagnostic yield was then calculated for each method and compared across tumor types, locations, and stages. Results: Among 142 patients, the overall diagnostic yield using combined bronchoscopic techniques was 85.9%. BAL had the highest individual yield (70.4%), followed by BX (57.7%) and BR (25.4%). Combining sampling methods significantly enhanced diagnostic accuracy compared to individual methods. Diagnostic yield was not significantly affected by tumor location or TNM stage. The highest yield was observed in adenocarcinoma and centrally located tumors. Conclusion: The combined use of BAL, BX, and BR significantly increases diagnostic yield in suspected bronchial carcinoma. Endobronchial biopsy and BAL are still the most effective individual techniques. A multimodal bronchoscopic approach should be employed for optimal diagnostic accuracy.References
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