Determinants of diagnostic bronchial washing in peripheral lung cancers

Abstract

OBJECTIVE: To establish clinical determinants affecting the diagnostic yield of bronchial washing. SETTING: We performed bronchial washing in 241 consecutive patients with bronchoscopically invisible lung tumours. Of these, 150 patients known to have lung cancer were enrolled for the final analysis. DESIGN: A multi-centre study. RESULTS: Bronchial washing provided a diagnosis of lung cancer in 30 of the 150 patients (20%). Tumour size >= 3 cm (P = 0.005), the location of the turnout within 8 cm of the carina (P = 0.003), and exposed type bronchus sign of turnout (P < 0.001) were factors affecting diagnostic bronchial washing for bronchoscopically invisible lung cancers. However, multivariate logistic regression revealed that exposed type bronchus sign was the sole determinant (OR 19.22, 95% CI 4.23-87.46, P < 0.001). CONCLUSION: Bronchial washing is a useful procedure for the diagnosis of bronchoscopically invisible lung cancers. As the tumour-bronchus relationship is the most important determinant of a diagnostic yield, the routine use of bronchial washing should be considered for tumours with exposed type bronchus sign.