Bronchial Washing Yield Before And After Forceps Biopsy In Patients With Endoscopically Visible Lung Tumors

Abstract

Introduction: Different factors, including tumor size and location and the operator's level of expertise, can affect the diagnostic yield of bronchial washing both before and after forceps biopsy in patients showing endoscopically evident lung tumors. The current study aimed to compare the diagnostic yield of bronchial washing conducted before and after forceps biopsy in patients presenting with visible lung tumors during endoscopy.

Materials and methods: A prospective study was carried out on 50 patients with endoscopically visible tumors in Shar teaching hospital and endoscopic units of Smart and Baxshin hospitals over a period of 18 months. The patients were divided into a bronchial washing before forceps biopsy (pre-biopsy) group and a biopsy group. Bronchial washing and forceps biopsy were performed under cytological and histopathological analysis respectively. The collected data were analyzed using SPSS (24.0).

Results: The patients' mean age was 72.06 years, ranging from 50 to 99 years. Most of the patients (72%) were males, and 28% were females. The main complaint was reported to be chronic cough (56%), followed by dyspnea (20%), and hemoptysis (12%). CXR was abnormal in 76% of them. Their mass size ranged from 3 to 7 cm. The most frequent previous medical history was hypertension (20%), followed by ischemic heart disease (14%). Most of the endobronchial lesions (80%) were tumorous, and 14% were infiltrative. Pre-BW and post-BW were positive in 42% and 46% of the patients, respectively. Also, 44% of the lesions were squamous, 36% were adeno, and 16% were SCLC. A significant difference was seen between the pre-BW and post-BW (p-value<0.001). No significant relationships were seen between the morphology of endobronchial lesions and pre-BW and post-BW (p-value>0.05). Moreover, biopsy of the endobronchial lesions was not significantly correlated with pre-BW and post-BW (p-value>0.05).

Conclusion: As suggested by the results of the current study, bronchial washing before forceps biopsy (pre-biopsy) and bronchial washing after forceps biopsy (post-biopsy) do not have a significant effect on the yield of the diagnostic outcomes.