Diagnostic Performance of Bronchoscopy in Lung Cancer and/or Pulmonary Metastasis: A Real Aspect of our Country

Abstract

Objective: To evaluate the diagnostic performance of different bronchoscopic sampling techniques in patients with suspected lung cancer and/or pulmonary metastasis at the General Hospital of Mexico, a center without access to endobronchial ultrasound (EBUS).

Methods: A retrospective analysis was conducted on bronchoscopies performed between 2018 and 2023 in patients with suspected lung cancer. Diagnostic results obtained from endobronchial biopsies, bronchial brushing, and bronchoalveolar lavage were analyzed. Histopathological results were used to determine the efficacy of each technique.

Results: A total of 122 bronchoscopies were performed, of which 100 resulted in positive diagnoses of lung cancer via bronchoscopy, and 22 cases were subsequently confirmed by surgical biopsy. The endobronchial biopsy had a success rate of 98.4% in endobronchial tumors, while bronchial brushing and bronchoalveolar lavage showed diagnostic rates of 7.8% and 1.6%, respectively. The most frequent histological types were lung adenocarcinoma (27.0%) and squamous cell carcinoma (23.8%). Postoperative complications occurred in 27.3% of patients undergoing surgery, with a mortality rate of 13.6%.

Conclusions: Bronchoscopy is an essential tool in the diagnosis of lung cancer at the General Hospital of Mexico, especially in the absence of EBUS. Endobronchial biopsy demonstrated high diagnostic efficacy, in contrast to bronchial brushing and bronchoalveolar lavage, which were significantly less effective. These findings underscore the need to improve diagnostic techniques in centers with technological limitations.