Diagnostic Procedures for Lung Cancer According to Histological Types and Their Complications

BACKGROUND/AIMS This study aimed to investigate if there are any differences between the diagnostic methods used in biopsy for lung cancer on the basis of the histological cell types. In addition, the contribution of bronchoscopic washing in the diagnosis of lung cancer and complications of flexible bronchoscopy and computed tomography (CT)-guided transthoracic needle biopsy (TNB) were also investigated. MATERIAL and METHODS The patients who were diagnosed with lung cancer pathologically were divided into two groups-bronchoscopic biopsy and CT-guided TNB. A comparison was made between the two groups according to the lung cancer cell type. Complication rates for both procedures were calculated. In addition, the contribution of bronchoscopic washing in the diagnosis of lung cancer was also investigated in patients who underwent bronchoscopy. RESULTS The study included 182 lung cancer patients, out of whom 106 patients were diagnosed by bronchoscopy and 76 patients were diagnosed by CT-guided TNB. There was no significant difference between the diagnostic approaches for adenocarcinoma (ADC) (p=.22). Small cell lung cancer (SCLC) and squamous cell carcinoma (SCC) were diagnosed more accurately by bronchoscopy than TNB (p=.01, p=.01, respectively). Bronchoscopic washing was found to be positive in 3 of the patients who had negative results with bronchoscopic biopsy. There were no major complications related to bronchoscopy. The total minor complication rate of bronchoscopy was found to be 11.3%. Pneumothorax was detected in 17% of patients undergoing TNB and the total complication rate of TNB was 19.7%. CONCLUSION SCLC and SCC were more accurately diagnosed by flexible bronchoscopy than TNB. Bronchoscopic washing contributed in the diagnosis of lung cancers. Flexible bronchoscopy was found to be much safer and associated with lower complication rates than CT-guided TNB.