Outcome of bronchial carcinoma in situ

Introduction: The proportion of patients with carcinoma in situ in whom inv asive cancer will develop is not known. It is important for clinical decisi on making to know the outcome of these lesions. The same applies for studie s assessing the effectiveness of chemoprevention treatment or endobronchial therapy. Methods: The records of patients with a bronchial carcinoma in situ who had undergone autofluorescence bronchoscopic examinations at regular intervals during a follow-up period for at least 6 months were reviewed. Data were e xamined for the outcome of carcinoma in situ, and for the detection, course , and bronchoscopic findings of neoplastic lesions at other bronchial sites . Results: Progression to carcinoma occurred in five of nine patients (56%) w ith a carcinoma in situ. Eight neoplastic lesions were detected at other si tes in four of the nine patients (44%). In earlier biopsy specimens of two sites that later showed a severe dysplasia and a carcinoma, only normal epi thelium was found. Biopsies had been performed at these sites because they were assessed as suspicious during autofluorescence bronchoscopy. Conclusion: The majority of sites showing a carcinoma irt situ progressed t o invasive carcinoma. A considerable portion of the patients had neoplastic lesions at other bronchial sites. The fluorescence pattern of the bronchia l mucosa may reflect early changes that are not found at histopathologic ex amination, but which may progress to neoplastic growth.