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Ann Thorac Surg 2003;76:1668-1672
© 2003 The Society of Thoracic Surgeons

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Original article: general thoracic

Contributions of bronchoscopic microsampling in the supplemental diagnosis of small peripheral lung carcinoma

^a DEPARTMENT OF Surgery, Keio University School of Medicine, Tokyo, Japan
^c DEPARTMENT OF Pathology, Keio University School of Medicine, Tokyo, Japan
^b Tokyo Electric Power Company Hospital, Tokyo, Japan
^d Pharmacia-Keio Research Lab, Tokyo, Japan

Accepted for publication April 22, 2003.

^* Address reprint requests to Dr Watanabe, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
e-mail: masazumi{at}sc.itc.keio.ac.jp

BACKGROUND: Making a preoperative pathologic diagnosis in patients with small lung nodules remains challenging. We have developed a new, noninvasive bronchoscopic microsampling probe to examine biochemical substances in epithelial lining fluid. We used this probe to measure tumor markers in fluid from tissues surrounding lung nodules less than 30 mm in diameter to test its adjunctive diagnostic utility in lung cancer.

METHODS: In 12 patients, epithelial lining fluid was collected in triplicate or duplicate from tissue within 2 cm of small peripheral lung nodules and from the contralateral lung. The diagnosis of adenocarcinoma was surgically confirmed in all patients. Fifteen patients without lung cancer served as controls. Concentrations of carcinoembryonic antigen, cytokeratin fragment 19, and sialyl SSEA-1 were measured in the fluid.

RESULTS: Carcinoembryonic antigen and cytokeratin fragment 19 concentrations were significantly higher in fluid near the nodules (median, 8.7 and 87.2 ng/mg, respectively) than on the contralateral sides (median, 1.5 and 3.7 ng/mg, respectively) or in fluid collected from the controls (median, 2.0 and 2.8 ng/mg, respectively).

CONCLUSIONS: Measurements of carcinoembryonic antigen and cytokeratin fragment 19 collected by our microsampling probe may be a useful diagnostic adjunct in patients with small peripheral lung nodules.

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