Abstract
After long study on sputum cytology and direct biopsy from pulmonary lesion, thosemethods of exfoliation with broncho-catheter, needle biopsy and direct biopsy throughbronchofiberscope have been remarkably improved for definitive diagnosis of lung cancer.The diagnostic rate has become over 90%. In Japan, definitive diagnosis of peripherallung cancer has been greatly improved thanks to the direct specimen exfoliative methodunder TV control, using flexible curette or crush introduced into the bronchus throughMétras' Sonde developed by Tsuboi. The direct specimen exfoliative methods are mainlydevided into two ways; with broncho-catheter and with bronchoscope.
The first biopsy method was develoved by use of rigid bronchoscope, which enabledcytological and histological diagnosis under direct observation of lesions. However, thismethod was effective only for the diagnosis of lung cancer located in the main bronchus, since the visible field was limited for rigid bronchoscope. The development of flexiblebronchofiberscope has extended the visible range up the IV to V ordering of bronchuswhich could not be visualized with a conventional rigid bronchoscope.
Additionally, the development of specimen collecting instruments has made the directspecimen exfoliative method much easier. The authors have got 95.5% definitivediagnostic rate; 234 out of 245 lung cancer cases, with only 11 negative cases. In thispaper, the result of cytological examination with bronchofiberscope as a definitive diagnosticmethods for lung cancer was presented along with the study on the negative cases.
