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Risk of lung cancer in patients with preinvasive bronchial lesions followed by autoflurescence bronchoscopy and chest computed tomography

Alaa Mohamed, Shibuya Kiyoshi, T. Fujiwara, W. Hironobu, H. Hoshino, S. Yoshida, M. Suzuki, K. Hiroshima, Y. Nakatani, Aliae Mohamed-Hussein, Maha Elkouly, Tarek Mahfouz, I. Yochino
European Respiratory Journal 2011 38: p1974; DOI:
Alaa Mohamed
1Chest Dept., Assiut University Hospitals, Assiut, Egypt
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Shibuya Kiyoshi
2Thoracic Surgury, Chiba University, Chiba, Japan
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T. Fujiwara
2Thoracic Surgury, Chiba University, Chiba, Japan
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W. Hironobu
2Thoracic Surgury, Chiba University, Chiba, Japan
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H. Hoshino
2Thoracic Surgury, Chiba University, Chiba, Japan
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S. Yoshida
2Thoracic Surgury, Chiba University, Chiba, Japan
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M. Suzuki
2Thoracic Surgury, Chiba University, Chiba, Japan
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K. Hiroshima
2Thoracic Surgury, Chiba University, Chiba, Japan
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Y. Nakatani
2Thoracic Surgury, Chiba University, Chiba, Japan
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Aliae Mohamed-Hussein
1Chest Dept., Assiut University Hospitals, Assiut, Egypt
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Maha Elkouly
1Chest Dept., Assiut University Hospitals, Assiut, Egypt
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Tarek Mahfouz
1Chest Dept., Assiut University Hospitals, Assiut, Egypt
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I. Yochino
2Thoracic Surgury, Chiba University, Chiba, Japan
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Abstract

Introduction and aim of the work: To assess risk of lung cancer (LC) in patients with preinvasive bronchial lesions and to identify factors associated with higher risk.

Patients and methods: 124 patients with one or more preinvasive bronchial lesions and normal chest computed tomography (CT) (mean age 66.7 years, 121 males and 3 females), followed-up by white light and autofluorescence bronchoscopy (AFB) every 4-6 mo and chest CT every 6-12 mo, end points were development of carcinoma in situ (CIS) or LC.

Results: Among 124 patients with 240 preinvasive bronchial lesions, 20 CIS or LC lesions were detected during follow-up in 20 (16%) patients, 7 were detected as new endobronchial lesions, 10 as new peripheral lesions and 3 as local progression from severe dysplasia to CIS. Median time to progression was 24 months (range: 6-54 mo). The Cumulative risk of progression was 7% at one year, 20% at three years and 44% at 5 years. Among detected lung cancers, 80% were stage 0 or stage1 and underwent treatment with curative intent. Diagnosis of new SD during follow-up (p=0.0001), chronic obstructive pulmonary disease (COPD) (p = 0.001) or smoking index >52 packyear (p = 0.042) was associated with higher risk. Even after controlling for other risk factors,COPD was associated with risk of progression. Baseline lesion grade was not predictive of patient outcome (p = 0.146).

Conclusions: Patients with preinvasive bronchial lesions, especially those with new SD during follow-up, COPD or smoking >52 pack-year are at high risk of LC, AFB and CT follow-up facilitated early detection and treatment with curative intent.

  • © 2011 ERS
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Risk of lung cancer in patients with preinvasive bronchial lesions followed by autoflurescence bronchoscopy and chest computed tomography
Alaa Mohamed, Shibuya Kiyoshi, T. Fujiwara, W. Hironobu, H. Hoshino, S. Yoshida, M. Suzuki, K. Hiroshima, Y. Nakatani, Aliae Mohamed-Hussein, Maha Elkouly, Tarek Mahfouz, I. Yochino
European Respiratory Journal Sep 2011, 38 (Suppl 55) p1974;

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Risk of lung cancer in patients with preinvasive bronchial lesions followed by autoflurescence bronchoscopy and chest computed tomography
Alaa Mohamed, Shibuya Kiyoshi, T. Fujiwara, W. Hironobu, H. Hoshino, S. Yoshida, M. Suzuki, K. Hiroshima, Y. Nakatani, Aliae Mohamed-Hussein, Maha Elkouly, Tarek Mahfouz, I. Yochino
European Respiratory Journal Sep 2011, 38 (Suppl 55) p1974;
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More in this TOC Section

  • Liquid-based cytology in the diagnosis of pulmonary malignancy in bronchial brushings and washings
  • Endobronchial ultrasound and fluoroscopy in the study of peripheral lung lesions
  • Diagnosis of pulmonary nodules localized beyond the range of standard bronchfiberoscope – Preliminary results
Show more 244. Progress in endoscopy for the diagnosis of lung cancer

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