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.