Synchronous invasive or preinvasive bronchial lesions detected by autofluorescence bronchoscopy in patients with lung cancer

Objectives: In support with field cancerization theory, some patients with lung cancer (LC) will also have synchronous invasive or pre-invasive bronchial lesions. In this cross sectional – analytic study autofluorescence bronchoscopy (AFB) was used to assess the prevalence of synchronous lesions in patients with LC. Materials and methods: All patients with abnormal sputum cytology underwent white light and AFB. From 335 patients with abnormal sputum cytology referred for AFB, lung cancer was detected in 91 patients (89 male and 2 female) of age (mean ± SD), 67 ± 8 years. 77 had squamous cell carcinoma (SqCC), 13 had adenocarcinoma and one patient with small cell lung cancer (SCLC). Results: Synchronous lesions detected in 26 (29%) patients, 25 (33%) of patients with SqCC, one with adenocarcinoma, no synchronous lesion detected in one patient with SCLC. The most severe detected synchronous lesion was adenocarcinoma in one patient, Carcinoma insitu (CIS) in 4 patients, severe dysplasia in 3 patients, moderate dysplasia in 10 patients, and mild dysplasia in 8 patients. Synchronous lesions were more frequently detected in current smokers (35%), than in ex-smokers (20%) and non-smokers (15%). Conclusion: Synchronous preinvasive lesions are frequent in patients with LC and AFB should be included in pre-operative evaluation of these patients