%0 Journal Article %A Carles Grimau %A Guadalupe Bermudo %A Luis Urrelo %A Miguel Gallego %A Eduard Monso %T Improvement in endoscopic diagnosis of lung cancer by narrow-band imaging (NBI) %D 2015 %R 10.1183/13993003.congress-2015.PA2994 %J European Respiratory Journal %P PA2994 %V 46 %N suppl 59 %X Aim: To define narrow band Imaging (NBI) patterns recognizing mucosal areas infiltrated by malignant tissue, independently of white ligh (WL) appearance, in patients at suspicion for lung cancer (LC).Methods: Bronchial mucosa of the lobe harbouring the primary lesion was examined with WL and NBI in patients with suspected LC, and a biopsy was performed in the visible part of the corresponding segmental bronchus, independently of their WL appearance. Bronchial abnormalities at WL were categorized as low (atrophy or flat thickening) or high suspicion (irregular thickening or tumor) for LC. Three types of vascular abnormalies (VA) were recognized by NBI in the samples areas, categorized as complex vascular structure (C), dotted vessels (D), and spiral or winding vessels (S). VA were considered as extensive when affecting a length equal or higher than the 50% the of the sampled or its nearest spur.Results: Bronchial biopsy showed LC in 17/43 patients (39%). Extensive VA were more prevalent in LC than in non-malignant areas (C 13[76%] vs 12[46%]; D 14[82%] vs 3[11%]; S 10[59%] vs 2[8 %]), with statistically significant differences for patterns D and S (p <0.001). Extensive pattern for D and/or S (DS) was observed in 17 malignant (100%), and in 5 non-malignant areas (19%) (p <0.001) and attained a 100% sensitivity and 80% specificity for malignancy identification. A DS pattern was identified in 9 of 30 patients with a low suspicion WL, with LC iat the biopsy n 4 of them.Conclusion: A NBI appearance with extensive vascular DS pattern in lobes harbouring a primary lesion improves the sensitivity of the endoscopy procedure over 20% for the identification of LC. %U