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. 2022 Sep 16:12:998770.
doi: 10.3389/fonc.2022.998770. eCollection 2022.

The value of narrow-band imaging bronchoscopy in diagnosing central lung cancer

Juanjuan Zhu  1   2   3 , Rui Liu  1   2 , Xiancheng Wu  1   2 , Qin Li  1   2   4 , Beilei Gong  1   2 , Yuanbing Shen  1   2 , Yurong Ou  5 , Wei Li  1   2
Affiliations

The value of narrow-band imaging bronchoscopy in diagnosing central lung cancer

Juanjuan Zhu et al. Front Oncol. .

Abstract

Aims: This research aimed to study the value of narrow-band imaging(NBI) in the diagnosis of central lung cancer.

Materials and methods: This study included 916 patients with clinical suspected of central lung cancer or follow-up of patients after curative lung cancer surgery. All of the patients were examined by Olympus Evis Lucera electronic bronchoscope system, any sites that were abnormal when viewed by white-light bronchoscopy (WLB) or NBI were biopsied, four to six biopsies were taken at each site of the abnormal region visualized as lesions, we record the endoscopic features of NBI and compared with histopathology results, to evaluate the diagnostic value of NBI for central lung cancer and the relationship between vascular patterns of NBI and histological types of lung cancer, and try to establish a multinomial logistic regression model for predicting the histological types of lung cancer. The biopsy specimens were examined by CD34 antibody through immunohistochemistry (IHC) method, CD34 marked microvessel density(MVD), compared the number of microvessels between benign and malignant diseases and the number between different histological types of lung cancer, to verify the results of NBI.

Results: NBI provided high sensitivity (91.7%), specificity (84.9%), positive predictive value (97.6%), negative predictive value (61.5%), and agreement rate (90.7%). The predominant vascular patterns in the well-defined histological types of lung cancer were dotted blood vessels (121 patients), tortuous blood vessels (248 patients), and abrupt-ending blood vessels (227 patients). Logistic regression analysis of the results showed that smoking status of the patient, combined with vascular patterns under NBI, and age partly affect the histological types of lung cancer.

Conclusions: NBI is highly accurate for the diagnosis of central lung cancer.

Keywords: CD34; central lung cancer; diagnosis; histological type; narrow-band imaging; vascular pattern.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A)ROC curve of NBI in the diagnosis of central lung cancer. (B)The proportion of different vascular patterns in benign lesions. (C)The proportion of different vascular patterns in lung cancer.
Figure 2
Figure 2
The proportion of vascular patterns in different histological types of lung cancer.
Figure 3
Figure 3
Comparison of MVD value between benign and malignant lesions.
Figure 4
Figure 4
Comparison of MVD value for SCC, adenocarcinoma, and SCLC.
Figure 5
Figure 5
The vascular images of WLB, NBI and histological specimens after IHC for malignant lesions. (A) Dotted blood vessels in adenocarcinoma of the lung (a) WLB image. (b) NBI shows that there are obvious dotted blood vessels. (c, d) IHC staining of the tissue specimen shows that there are obvious dotted blood vessels(the scale of Figure c is 100μm, the scale of Figure d is 50μm). (B) Tortuous blood vessels in SCC of the lung (a) WLB image. (b) NBI shows that there are obvious tortuous blood vessels. (c, d) IHC staining of the tissue specimen shows that there are obvious tortuous blood vessels(the scale of Figure c is 100μm, the scale of Figure d is 50μm). (C) Abrupt-ending blood vessels in SCC of the lung (a) WLB image. (b) NBI shows that there are obvious abrupt-ending blood vessels. (c, d) IHC staining of the tissue specimen shows that there are obvious abrupt-ending blood vessels(the scale of Figure c is 100μm, the scale of Figure d is 50μm). (D) Tortuous blood vessels in SCLC of the lung (a) WLB image. (b) NBI shows that there are obvious tortuous blood vessels. (c, d) IHC staining of the tissue specimen shows that there are obvious tortuous blood vessels (the scale of Figure c is 100μm, the scale of Figure d is 50μm).
Figure 6
Figure 6
CIS is shown as lesions with only dotted blood vessels, small spiral or screw type tumor vessels, and a few tortuous vessels under NBI. (A) WLB image. (B) NBI shows that there are a few dotted, small spiral or screw type, and tortuous vessels. (C, D) IHC staining of the tissue specimen shows that there are obvious tortuous blood vessels [the scale of (C) is 100 μm, the scale of (D) is 50 μm].
Figure 7
Figure 7
Fewer and regular blood vessels in inflammation of the lung. (A) WLB image. (B) NBI shows that there are fewer and regular blood vessels. (C, D) IHC staining of the tissue specimen shows that there are fewer and regular blood vessels [the scale of (C) is 100 μm, the scale of (D) is 50 μm].
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References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. . Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin (2021) 71(3):209–49. doi: 10.3322/caac.21660 - DOI - PubMed
    1. Cao W, Chen HD, Yu YW, Li N, Chen WQ. Changing profiles of cancer burden worldwide and in China: A secondary analysis of the global cancer statistics 2020. Chinese Med J (2021) 134(7):783–91. doi: 10.1097/CM9.0000000000001474 - DOI - PMC - PubMed
    1. Ning J, Ge T, Jiang M, Jia K, Wang L, Li W, et al. . Early diagnosis of lung cancer: Which is the optimal choice? Aging (Albany NY) (2021) 13(4):6214–27. doi: 10.18632/aging.202504 - DOI - PMC - PubMed
    1. Yang X, Lin D. Changes of 2015 WHO histological classification of lung cancer and the clinical significance. Zhongguo Fei Ai Za Zhi. (2016) 19(6):332–6. doi: 10.3779/j.issn.1009-3419.2016.06.06 - DOI - PMC - PubMed
    1. Andolfi M, Potenza R, Capozzi R, Liparulo V, Puma F, Yasufuku K. The role of bronchoscopy in the diagnosis of early lung cancer: A review. J Thorac Dis (2016) 8(11):3329–37. doi: 10.21037/jtd.2016.11.81 - DOI - PMC - PubMed

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