Fiberoptic bronchoscopy. Comparison of procedures used in the diagnosis of lung cancer.

We have compared the relative value of various techniques used in association with fiberoptic bronchoscopy for the diagnosis of lung cancer. We analyzed the results in 114 patients who underwent diagnostic fiberoptic bronchoscopy and in whom a definite histologic diagnosis of lung cancer was made. A comparison of the diagnostic yield from cytologic examination of prebronchoscopy and postbronchoscopy sputum and of fiberoptic bronchial biopsy, brushing, and washing was made. Over-all, bronchial washings gave the highest diagnostic yield (75.4%) and forceps biopsy the next higher (65.8%). The combination of bronchial washings and forceps biopsy gave the highest diagnostic yield (95.8%). In six patients, postbronchoscopy sputum was the only source of positive diagnostis; in 20 patients only one procedure was positive. Our results suggest that although fiberoptic bronchoscopy washings and forceps biopsy have the highest diagnostic yield, brushings and postbronchoscopic sputum examination are also important diagnostic maneuvers and should be routinely performed.