Abstract
In order to establish endoscopic diagnosis of chronic bronchitis and clarify the problems concerning “aging of the bronchus, ” we investigated the correlation between the appearance of atrophic changes of the bronchi and sex, age, smoking and various diseases, particularly chronic bronchitis, in 683 patients who underwent bronchoscopic examination. Endoscopic findings of atrophic changes of the bronchi are as follows: a) pale-colored, white-spotted and uneven surface; b) marked prominence of cartilage; c) five or more numbered, clearly observed and narrow longitudinal corrugations found in pars cartilaginea; d) transverse ridge; and e) any longitudinal corrugation found in pars cartilaginea.
The following results were obtained:
1) Atrophic changes of the bronchi were found in 162 (38.1%) of the 425 male patients and 42 (16.3%) of the 204 female patients.
2) Atrophic changes of the bronchi appeared from the third decade of age in both sexes and increased with age.
3) The influence of smoking on appearance of atrophic changes of the bronchi was demonstrated in men.
4) Among the underlying diseases, atrophic changes of the bronchi were most frequently found in chronic bronchitis, and also frequently in pulmonary tuberculosis and bronchiectasis.
5) In chronic bronchitis, atrophic changes of the bronchi were found more frequently in patients undergoing examination more than four years after the onset of disease than in those examined less than four years after onset.
6) Patients with chronic bronchitis complicated by lung cancer numbered 31 males and 3 females. Almost all males were heavy smokers, and in those males squamous cell carcinoma and small cell carcinoma of hilar type dominated.
