廣島 健三

Our aim was to assess natural history of bronchial squamous dysplasia detected by fluorescence bronchoscopy, that is, which dysplasia has potential to progress to invasive cancer. We could periodically follow up dysplasias detected by fluorescence bronchoscopy, and were subjects of this study. We assessed the correlation among histological outcome and smoking status during the follow-up period, and telomerase activity, Ki-67 labeling index, and p53 immunoreactivity of initial biopsy specimens. Some of dysplasias developed to squamous cell carcinoma, some maintained dysplasias, and another regressed to normal bronchial epithelium. Dysplasia with high telomerase activity, increased Ki-67 labeling index, and p53 positive immunoreactivity tends to remain dysplasia, and have potential to progress to invasive cancer.

Our aim was to evaluate whether the use of fluorescence bronchoscopy following conventional white-light bronchoscopy examination is useful in the early diagnosis of preinvasive bronchial lesions of the tracheobronchial tree. Patients with abnormal sputum cytology were referred to our institute and examined with both white-light and fluorescence bronchoscopy. All abnormal areas discovered by white-light or fluorescence bronchoscopy examination or both, had biopsy specimens taken for pathological examination. Forty-five lesions were revealed to be preinvasive bronchial lesions. Multicentric lesions were observed in 17 patients in this study. Examination using a fluorescence bronchoscopy, in addition to conventional white-light examination, was found to enhance the detection and localization of preinvasive bronchial lesions.