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        기관지내 전암성 병변 발견을 위한 자가 형광 기관지 내시경의 유용성

        이연선 ( Yeun Seun Lee ),정미경 ( Mi Kyong Jeuong ),이유진 ( Yu Jin Lee ),장필순 ( Pill Soon Jang ),이정은 ( Jeung Eun Lee ),박희선 ( Hee Sun Park ),정재욱 ( Chae Uk Chung ),정성수 ( Sung Soo Jung ),김선영 ( Sun Young Kim ),김주옥 대한내과학회 2006 대한내과학회지 Vol.71 No.1

        Background: Autofluorescence bronchoscopy (AFB), when used as an adjunct to conventional white light bronchoscopy (WLB) improves the bronchoscopist`s ability to localized small intraepithelial lesions. Current study was undertaken to evaluate prevalence of preinvasive intraepithelial lesions (dysplasia II-III & CIS) and efficacy of additional AFB system to WLB in comparison with WLB alone. Methods: In patients with suspicion of lung cancer or follow-up ones with known lung cancer, WLB (Pentax; BP 3500, Japan) and AFB (Richard Wolf, Germany) were done and all subjects with endoscopic abnormalities underwent biopsies from January 2005 to December 2005. Results: 169 patients (134 suspected to have lung cancer radiologically, 18 with known lung cancer, and 17 with initial abnormal WLB visual findings) were enrolled. Overall preinvasive intraepithelial lesions were detected in 6.5% (11 persons). Biopsy based sensitivity of WLB+AFB and WLB alone for detecting preinvasive intraepithelial lesions was 77.8% compared with 22.2% (relative ratio 3.5, 95% CI 0.93-13.24). Corresponding specificity was 56.9% compared with 89.2% (relative ratio 0.64, 95% CI 0.54-0.75). The positive predicitve value was 6% and 3%, and the negative predictive value was 94% and 87%, respectively, for WLB+AFB and WLB alone. Conclusions: WLB+AFB was superior to WLB alone in detecting preinvasive intraepithelial lesions, but general use of AFB as a screening tool seems to be limited in suspected or known lung cancer group because of low prevalence. It is necessary of further study for precise indication for AFB among the lung cancer risk groups.(Korean J Med 71:67-74, 2006)

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