AUTOFLUORESCENCE BRONCHOSCOPY IN THE DETECTION OF SQUAMOUS METAPLASIAAND DYSPLASIA IN CURRENT AND FORMER SMOKERS

Background: New methods are needed to detect precancerous lesions in l ung tissue. We conducted a study to determine the utility of LIFE(TM) (laser-induced fluorescence emission) autofluorescence bronchoscopy fo r the detection of squamous metaplasia and dysplasia in current and fo rmer smokers. Methods: In this prospective, single-center study, 53 pa rticipants underwent standard white-light bronchoscopy and 39 underwen t both white-light and LIFE bronchoscopy, Bronchial biopsy specimens w ere obtained from all participants at six predetermined sites using wh ite-light bronchoscopy and from all other sites that appeared to be ab normal in participants who underwent LIFE bronchoscopy, Relationships between LIFE imaging and histologic findings were examined for 245 bio psy specimens obtained from those participants who had undergone LIFE bronchoscopy, Results: LIFE imaging revealed abnormalities designated as either class II or class III in 89 (36.3 %) and 16 (6.5 %) of the 2 45 sites examined, respectively, and histopathologic examination showe d dysplasia and metaplasia in eight (3.3%) and in 52 (21.2%) of the 24 5 specimens, respectively. Among the 105 biopsy specimens obtained fro m sites with abnormal LIFE imaging, only 26 (24.8%) exhibited squamous metaplasia and/or dysplasia, similar to the findings for sites with n ormal LIFE imaging (34 [24.3%] of 140), Comparison of individuals exam ined by LIFE imaging with those who underwent white-light bronchoscopy alone revealed no increase in the detection of dysplasia or metaplasi a with LIFE bronchoscopy. Conclusion: In this population of current an d former smokers, abnormalities detected by LIFE bronchoscopy did not improve the detection of squamous metaplasia or dysplasia.