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Diagnostic Yield of Bronchoscopy Guided Procedures in Lung Cancer including conventional TBNA

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Author(s): Patil Shital1 and Agarwal K C2, Purohit Gopal3, Gupta Madhu4 and Singh Deepak5

Journal: Journal of Medical Education and Research
ISSN 2249-9660

Volume: 02;
Issue: 02;
Start page: 21;
Date: 2012;
Original page

Keywords: Lung Cancer | Bronchoscopy | TBNA | CDTs(Conventional Diagnostic Techniques)

ABSTRACT
Background- Lung Cancer is the leading cause of cancer deaths around the world.Lung cancer has been the most common cancer worldwide since 1985 and is the largestcontributor to new cancer diagnosis and death from cancer. Lung cancer accounts for13.8% of all cancer diagnosis in India. Due to high prevalence of smoking behavior inrural and urban zones Lung cancer is the dominant category found in western part ofRajasthan. Since its introduction; fiberoptic bronchoscope has become an increasinglyimportant diagnostic and therapeutic tool in respiratory diseases including lung cancer.Various diagnostic techniques like Forcep biopsy, bronchial washing and bronchialbrushing, transbronchial needle aspiration cytology (TBNA) are employed duringfiberoptic bronchoscopy to increase the diagnostic yield.Methods- This is a prospective study conducted during March 2011- Sept.2012 atBronchoscopy unit of K N Chest Hospital Jodhpur, to find the role of TBNA techniqueduring Fiberoptic bronchoscopy and was compared to other CDTs in Diagnosing Lungmalignancies, included 210 patients on the basis of clinical and radiological features ofmalignancy. Fiberoptic Bronchoscopic abnormalities were categorized as ExophyticEndobronchial Lesions, Submucosal Lesions, Peribronchial Lesions and Noabnormality. TBNA and other CDTs like Forcep Biopsy, Bronchial Brush andBronchial Wash were performed during bronchoscopy procedure. Histopathologicaland cytological examinations of specimens were performed at Pathology department.The statistical analysis was done using Chi Square test.Results- In Exophytic Endobronchial Lesions, yield of TBNA, CDTs and TBNA plusCDTs were 62.60%, 79.67% and 84.55% respectively. Yield difference of all thesetechniques is highly significant (p0.8). In Peribronchial Lesions TBNA hassignificant yield i.e. 63.41% individually as compared to Forcep biopsy 26.82% andCDT 39.02% (p
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