DIAGNOSTIC-VALUE OF DIFFERENTIAL BRUSHING OF ALL BRANCHES OF THE BRONCHI IN PATIENTS WITH SPUTUM POSITIVE OR SUSPECTED POSITIVE FOR LUNG-CANCER

In roentgenographically occult lung cancer, it is often difficult to d etermine the location of the tumor despite the existence of cancer. Th is complicates diagnosis and points to a need for a more systematic me thod of examination. Differential brushing was performed on all the re spective segmental bronchi in both lungs of 196 patients with positive or suspected positive indications of lung cancer as revealed by sputu m cytology. Fifty-nine borderline lesions in 43 cases and 107 lung can cer lesions in 95 cases were diagnosed. Localization was possible in 7 0.4% of the cases. The diagnosis of borderline lesions was also possib le. At the first examination, the rate of localization, as compared wi th that in the historical control group, improved from 64.1% to 95.8%, and, in particular, an improvement from 0% to 86.2 % was noted in tho se cases in which abnormal bronchoscopic findings were not observed. C oncurrent multiple primary cancer was also diagnosed in 12.6% of lung cancer cases before treatment. With this method, cytologic findings in sputum and in specimens obtained by brushing and histologic findings of resected lung can be compared in an integrated manner, and hencefor th more accurate diagnostic criteria can be established.