| Updates in diagnostic bronchoscopy for lung cancer |
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Seok-Chul Yang |
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1Department of Cardiology, Catholic University of Daegu College of Medicine, Daegu, Korea |
| 종설: 폐암 진단에서 기관지내시경의 최신 정보 |
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양 석 철 |
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| Abstract |
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Despite therapeutic advances with minimally invasive surgical techniques, improved radiotherapy dosing with
3-dimensional planning, new chemotherapy agents and targeted therapies including epidermal growth factor receptor
tyrosine kinase inhibitor, monoclonal antibody and anti-angiogenesis agents, the 5-year overall survival for lung cancer has
remained relatively poor, mainly because by the time a diagnosis is made, lung cancer is often well advanced and
treatment options are limited. The majority of lung cancer cases are diagnosed in a late stage, when nonspecific symptoms
such as cough, dyspnea, and hemoptysis are present. Advances in early diagnostic and treatment options have the potential
to manage lung cancer. The diagnostic approach to lung cancer may be divided into two problems; first, establishing the
diagnosis and second, accuracy of staging. Bronchoscopy is now being used increasingly in the investigation and
management of a wide spectrum of malignant, infectious, inflammatory, and other diseases or pathology of the lungs.
There have been recently advances in bronchoscopic diagnosis of lung cancer; autofluorescence bronchoscopy,
endobronchial ultrasound, and electromagnetic navigation bronchoscopy. Autofluorescene bronchoscopy exploits the
inherent fluorescence property of cancerous tissue and improves detection of premalignant lesions not seen with white
light bronchoscopy. Endobronchial ultrasound utilizes a flexible ultrasound probe to image and biopsy lesions and lymph
nodes beyond the wall of the bronchus. Electromagnetic navigation bronchoscopy combines virtual bronchoscopy,
three-demensional CT images, and a steerable probe to help navigate a bronchoscope to a particular peripheral lung lesion
or lymph node. The purpose of this review is to describe current bronchoscopic advances in diagnosis and staging of lung
cancer. (Korean J Med 75:398-406, 2008) |
| Key Words:
Autofluorescence bronchoscopy; Endobronchial ultrasound; Electromagnetic navigation bronchoscopy; Lung cancer; Staging |
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