Bronchoscopy in the investigation of outpatients with hemoptysis at a lung cancer clinic
| Autor: | Marcus P. Kennedy, Kashif Ali Khan, Michael Henry, Barry J. Plant, Emily Bredin, Desmond M. Murphy, Parniya Arooj |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Hemoptysis Lung Neoplasms Malignancy Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine CT thorax Bronchoscopy medicine Humans Prospective Studies 030212 general & internal medicine Stage (cooking) Lung cancer Prospective cohort study False Negative Reactions Respiratory Tract Infections Aged Neoplasm Staging Retrospective Studies EBUS-TBNA medicine.diagnostic_test Respiratory tract infections business.industry Age Factors Cancer Retrospective cohort study Middle Aged respiratory system medicine.disease respiratory tract diseases 030228 respiratory system Female Radiology Tomography X-Ray Computed business |
| Popis: | Background In the investigation of lung cancer, current practice in many healthcare systems would support bronchoscopy regardless of CT findings in patients with hemoptysis. We sought to identify the cause, the diagnostic yield of CT and bronchoscopy and the requirement for bronchoscopy in at risk patients with hemoptysis with a normal CT scan through our rapid access lung cancer clinic (RALC). Methods Initially, a chart review was performed on all patients with hemoptysis (2011–2012) and thereafter a prospective analysis was performed (2013–2016). Results Our analysis represents the largest study to date in outpatients with hemoptysis. In our retrospective study, 155 patients reported hemoptysis. Causes were lower respiratory tract infections (RTIs) (47%) and lung cancer (16%). Our prospective study included 182 patients. The causes of hemoptysis were RTIs (50%) and lung cancer (18%). There were no false negative CT-scans for lung cancer. 47/57 present with lung cancer underwent bronchoscopy and 43/47 were positive for lung cancer (92%). Patients with hemoptysis and lung cancer have a higher stage of malignancy with a predominance of squamous cell lung carcinoma. Smoking status, the duration of hemoptysis or description of hemoptysis were not predictive of lung cancer however lung cancer was not identified in patients age Conclusions One sixth of patients presenting with hemoptysis to our lung cancer clinic had lung cancer. No patient identified with cancer related haemoptysis had a CT negative for lung cancer and a combination of bronchoscopy plus endobronchial ultrasound trans-bronchial needle aspiration (EBUS-TBNA) in those patients with a CT suspicious of lung cancer is 92% sensitive for lung cancer causing hemoptysis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|