[Autofluorescence bronchoscopy]

Due to advances in interventional bronchoscopy, curative treatment has become possible for central type lung cancer if it is detected in the early stage. However, expertise is required to diagnose the intraepithelial lesions by conventional white light bronchoscopy alone, but judgement is still subjective. The combination of white light and autofluorescence bronchoscopy has been reported to show better sensitivity in detecting dysplasia and cancer of the bronchus than white light alone. Thus, abnormal sputum cytology findings are good indications for this examination. Autofluorescence bronchoscopy also can capture the extent of tumor precisely, therefore it is helpful to decide the bronchial resection line preoperatively or the area to treat before endoscopic therapy. However, discrimination between cancerous/precancerous lesions and inflammation is sometimes difficult by endoscopic images alone, and histological diagnosis is still the gold standard. Recently, videoendoscopy-based autofluorescence systems have been created and used clinically. These systems had significantly higher sensitivity for intraepithelial lesions as well as higher specificity than white light videoendoscopy alone.