Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Beamis, J. F.
Right arrow Articles by Mathur, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Beamis, J. F., Jr
Right arrow Articles by Mathur, P.
(Chest. 2004;125:148S-149S.)
© 2004 American College of Chest Physicians

A Multicenter Study Comparing Autofluorescence Bronchoscopy to White Light Bronchoscopy Using a Non-Laser Light Stimulation System*

John F. Beamis, Jr, MD, FCCP; Armin Ernst, MD, FCCP; Michael Simoff, MD, FCCP; Rex Yung, MD, FCCP and Praveen Mathur, MBBS, FCCP

* From the Department of Pulmonary and Critical Care Medicine, Lahey Clinic (Dr. Beamis), Burlington, MA; Beth Israel Deaconess Medical Center (Dr. Ernst), Boston, MA; Henry Ford Health Systems (Dr. Simoff) Detroit, MI; Johns Hopkins Medical Center (Dr. Yung), Baltimore, MD; and Indiana University Medical Center (Dr. Mathur), Indianapolis, IN.

Correspondence to: John F. Beamis, Jr., MD, FCCP, Deprartment of Pulmonary and Critical Care Medicine, Lahey Clinic, 41 Mall Rd, Burlington, MA 01805; e-mail: John.F.Beamis{at}Lahey.org

Autofluorescence bronchoscopy (AF) has been shown to improve the detection of early central lung cancer. This study was designed to evaluate the D-light Autofluorescence System (Karl Storz Endoscopy America; Culver City, CA) in comparison to white light bronchoscopy (WL) in detecting class III (severe dysplasia, carcinoma in situ, early invasive cancer) in patients with known or suspected lung cancer. Patients with known or suspected lung cancer underwent diagnostic WL followed by AF. Findings were classified as follows: class I, normal; class II, normal, nonspecific; class III, abnormal/premalignant; and class IV, tumor. All class III lesions were sampled, along with two areas normal by AF and WL. Local and reference pathologists were blinded as to the location and bronchoscopic characteristics of the samples. The McNemar test was used to compare primary end points of sensitivity and specificity in AF vs WL. Exact {chi}2 was used to compare secondary end points, negative predictive value and positive predictive value, in AF vs WL. Three hundred patients were enrolled (180 men and 120 women, mean age, 65.4 years); 278 patients (93%) completed the protocol. Nine hundred one biopsy samples were obtained; 80 were excluded because of tumor or unsatisfactory. Eight hundred twenty-one biopsy samples from 293 patients (2.8 biopsy observations per patient) were analyzed. Under AF, sensitivity was 61.2%, compared to 10.6% under WL (p < 0.0001 by McNemar test). Specificity was 94.6% under WL and 75.3% under AF (p < 0.0001). Positive predictive value for AF was 22.2% vs 18.4% for WL (p = 0.49); negative predictive value for AF was 94.9% vs 90.2% for WL (p = <0.01). AF significantly improves the sensitivity of detecting class III mucosal lesions of the central airways. The negative predictive value of AF is superior to WL. Results with the D-light Autofluorescence System are similar to those reported with other laser-stimulated AF systems.


   Footnotes
 
Abbreviations: AF = autofluorescence bronchoscopy; WL = white light bronchoscopy





This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Beamis, J. F.
Right arrow Articles by Mathur, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Beamis, J. F., Jr
Right arrow Articles by Mathur, P.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS