Utilidad de la fibrobroncoscopia en el cáncer de esófago

Utilidad de la fibrobroncoscopia en el cáncer de esófago

Objective: To stablish the utility of the fiberoptic bronchoscopy (FOB) studies performed in patients with esophageal cancer (EC), and confirm the possibility of tracheo-bronchial compromise.

Patients and methods: We carry out a descriptive study in 226 patients with esophagea/ cancer during 1991 to 1996 in the Instituto Nacional de Cancerología of Colombia (I.N.C.). We excluded the patients with previous treatments: radiotherapy or surgery, and others primary cancers with metastases on the esophagus. We analized gastric, intestinal and general symptoms, smoking habits, primary cancer location, histologic types, radiologic findings, FOB findings, micro and macroscopes, and results of the samples: transbronchial, endobronchial byopsies, bronchioalveolar lavage and brush.

Results: We included 158 patients, 11 O mate and 48 fema/e, with age between 32 and 83 years, symptoms duration average of 5,2 months. The most significants were cough, disphonia and sputum. The location of EC was statistics significance only in the upper third (O.R: 6.45). escamocelular type (O.R: 6.41 ). The significants radio/ogic findings were: Parenchymal nodu/es (O. R: 5. 12) and intersticial infiltrates (O.R: 4.40). The significants FOB findings were: fistula (OR: 25.09), endobrochial infiltration (O.R: 4.48), endobronchial mass (O.R: 10.54) andvoca/ cords pa/sy (O.R: 5.46). The zones with more compromise were trachea, principal bronchi and vocal cords. Only 17 patients were positives in the samples; comparing the histopathologic findings (biopsies) as the gold standard with FOB findings the sensitivity was 100%, specificity 35%, positive predictive value 15.6% and negative predictive value 100%.

Conclusions: The FOB is a very sensible method to detect tracheobronchial compromise in patients with EC. The symptoms, radiographic alterations and EC location are a/so related, but they are lesser sensible than FOB.