Mr. Song, a 49-year-old patient with advanced lung cancer who has been smoking for more than 20 years, repeatedly cried out injustice: he attended physical examinations and took chest X-ray every year, but why did he fail to find any traces of tumor?
It is inevitable that traditional examination methods can miss one thing. For example, chest X-ray is familiar to everyone. If the size of tumor tissue is small or there is no significant difference in density with the surrounding normal tissue, no trace of tumor can be found on chest X-ray. Due to the influence of filming method, angle and body position, chest film can’t be able to “see everything”. This is probably the reason why Mr. Song failed to detect lung cancer in his chest X-ray every year. Another example is that sputum examination is an important means of detecting lung tumors, but it may not be able to detect all of them. Sputum examination requires a high standard of specimen collection, and sputum must be coughed up from deep bronchial tubes after waking up in the early morning to meet the requirement. Only when the lung cancer tissue grows into the bronchial tubes and the shed cells are mixed with the sputum, it is possible to detect it through sputum.
The above two are indirect means of lung cancer examination, which is a bit “scratching the itch”, but the introduction of white light bronchoscopy has brought lung cancer early diagnosis to a new level. With the help of it, doctors can directly see the lesions in the lumen of bronchial cavity, and furthermore, they can do biopsy of local tissues and adjacent mediastinal lymph nodes. However, it still has the drawback that it cannot see the early lesions under the mucosa.
Even the most rigorous examination may miss the early lesions, so the “carpet search” may not be effective. At this time, medical researchers have the bold idea – can we let the tumor tissue expose itself? Through unremitting efforts, a self-fluorescence bronchoscope, which allows early stage lung cancer to “announce itself”, was introduced. This bronchoscope has the same appearance as the ordinary white light bronchoscope, but the “trick” is that the light source is irradiated, and the early tumor tissue under the mucosa emits a different kind of fluorescence. With such a significant difference, it is possible to perform pathological biopsies on suspicious areas and detect “latent” diseases at an early stage.
Autofluorescence bronchoscopy started a little later in China, but is widely used in Europe, America and Japan. People who need this test include: moderate to severe atypical hyperplasia on sputum cytology, or no lesion on chest radiograph within 6 months but cancer is suspected; smokers who started smoking before the age of 20, smoke more than 20 cigarettes per day, have smoked for more than 20 years, and recently have untreated cough, hemoptysis and chest pain; people who have high suspicion of lung cancer and want to identify the lesion to guide biopsy; people who have early lung cancer and suspect recurrence; people who want to monitor the effectiveness of treatment of endotracheal tumors. To monitor the effect of treatment of endotracheal tumors in order to guide the positioning of endoluminal tumor treatment.
Mr. Song, a 49-year-old patient with advanced lung cancer who has been smoking for more than 20 years, repeatedly cried out injustice: he attended physical examinations and took chest X-ray every year, but why did he fail to find any traces of tumor?
It is inevitable that traditional examination methods can miss one thing. For example, chest X-ray is familiar to everyone. If the size of the tumor tissue is small or the density is not significantly different from the surrounding normal tissue, no trace of tumor can be found on the chest X-ray. Due to the influence of filming method, angle and body position, chest film can’t be able to “see everything”. This is probably the reason why Mr. Song failed to detect lung cancer in his chest X-ray every year. Another example is that sputum examination is an important means of detecting lung tumors, but it may not be able to detect all of them. Sputum examination requires a high standard of specimen collection, and sputum must be coughed up from deep bronchial tubes after waking up in the early morning to meet the requirement. Only when the lung cancer tissue grows into the bronchial tubes and the shed cells are mixed with the sputum, it is possible to detect it through sputum.
The above two are indirect means of lung cancer examination, which is a bit “scratching the itch”, but the introduction of white light bronchoscopy has brought lung cancer early diagnosis to a new level. With the help of it, doctors can directly see the lesions in the lumen of bronchial cavity, and furthermore, they can do biopsy of local tissues and adjacent mediastinal lymph nodes. However, it still has the drawback that it cannot see the early lesions under the mucosa.
Even the most rigorous examination may miss the early lesions, so the “carpet search” may not be effective. At this time, medical researchers have the bold idea – can we let the tumor tissue expose itself? Through unremitting efforts, a self-fluorescence bronchoscope, which allows early stage lung cancer to “announce itself”, was introduced. This bronchoscope has the same appearance as the ordinary white light bronchoscope, but the “trick” is that the light source is irradiated, and the early tumor tissue under the mucosa emits a different kind of fluorescence. With such a significant difference, it is possible to perform pathological biopsies on suspicious areas and detect “latent” diseases at an early stage.
Autofluorescence bronchoscopy started a little later in China, but is widely used in Europe, America and Japan. People who need this test include: moderate to severe atypical hyperplasia on sputum cytology, or no lesion on chest radiograph within 6 months but cancer is suspected; smokers who started smoking before the age of 20, smoke more than 20 cigarettes per day, have smoked for more than 20 years, and recently have untreated cough, hemoptysis and chest pain; people who have high suspicion of lung cancer and want to identify the lesion to guide biopsy; people who have early lung cancer and suspect recurrence; people who want to monitor the effectiveness of treatment of endotracheal tumors. To monitor the effect of treatment of endotracheal tumors in order to guide the positioning of endoluminal tumor treatment.
Mr. Song, a 49-year-old patient with advanced lung cancer who has been smoking for more than 20 years, repeatedly cried out injustice: he attended physical examinations and took chest X-ray every year, but why did he fail to find any traces of tumor?
It is inevitable that traditional examination methods can miss one thing. For example, chest X-ray is familiar to everyone. If the size of the tumor tissue is small or the density is not significantly different from the surrounding normal tissue, no trace of tumor can be found on the chest X-ray. Due to the influence of filming method, angle and body position, chest film can’t be able to “see everything”. This is probably the reason why Mr. Song failed to detect lung cancer in his chest X-ray every year. Another example is that sputum examination is an important means of detecting lung tumors, but it may not be able to detect all of them. Sputum examination requires a high standard of specimen collection, and sputum must be coughed up from deep bronchial tubes after waking up in the early morning to meet the requirement. Only when the lung cancer tissue grows into the bronchial tubes and the shed cells are mixed with the sputum, it is possible to detect it through sputum.
The above two are indirect means of lung cancer examination, which is a bit “scratching the itch”, but the introduction of white light bronchoscopy has brought lung cancer early diagnosis to a new level. With the help of it, doctors can directly see the lesions in the lumen of bronchial cavity, and furthermore, they can do biopsy of local tissues and adjacent mediastinal lymph nodes. However, it still has the drawback that it cannot see the early lesions under the mucosa.
Even the most rigorous examination may miss the early lesions, so the “carpet search” may not be effective. At this time, medical researchers have the bold idea – can we let the tumor tissue expose itself? Through unremitting efforts, a self-fluorescence bronchoscope, which allows early stage lung cancer to “announce itself”, was introduced. This bronchoscope has the same appearance as the ordinary white light bronchoscope, but the “trick” is that the light source is irradiated, and the early tumor tissue under the mucosa emits a different kind of fluorescence. With such a significant difference, it is possible to perform pathological biopsies on suspicious areas and detect “latent” diseases at an early stage.
Autofluorescence bronchoscopy started a little later in China, but is widely used in Europe, America and Japan. People who need this test include: moderate to severe atypical hyperplasia on sputum cytology, or no lesion on chest radiograph within 6 months but cancer is suspected; smokers who started smoking before the age of 20, smoke more than 20 cigarettes per day, have smoked for more than 20 years, and recently have untreated cough, hemoptysis and chest pain; people who have high suspicion of lung cancer and want to identify the lesion to guide biopsy; people who have early lung cancer and suspect recurrence; people who want to monitor the effectiveness of treatment of endotracheal tumors. monitoring the treatment effect of endotracheal tumor to guide the positioning of endoluminal tumor treatment.
A patient with advanced lung cancer was admitted to the respiratory ward – Mr. Song, who was only 49 years old. Due to the spread of tumor cells, his life had already started to count down, and what was even more saddening was that there were only two short months from the appearance of obvious symptoms to hospital admission. “Why couldn’t it be found earlier?” Mr. Song and his family asked helplessly. To be fair, Mr. Song is not unconcerned about his health, and he attends annual medical checkups at his own expense, and among the many checkups, a chest plain film is essential. He deliberately checked the films and records taken in the past years, and without exception, all of them were stamped as “no abnormality”. Why is there no trace of the tumor from its occurrence to the appearance of obvious symptoms for such a long time?
Traditional examination methods are inevitable to miss one thing
There are ten hidden areas in chest radiographs
The public is familiar with chest radiographs, which can reveal the internal lesions without opening the chest cavity, and medical imaging has brought a blessing to mankind. However, this is after all an indirect image, the nature of which is the difference in the absorption rate of X-rays by different tissues and organs. Therefore, if the size of tumor tissue is small or there is no significant difference in density with the surrounding normal tissue, no trace of tumor can be detected on the chest plain film. In addition, due to the influence of the film taking method, angle and body position, the chest plain film can not be able to “see everything” and there are ten hidden areas. If the tumor grows in these areas, no matter how many chest films are taken, the lesion cannot be detected at an early stage. This is probably the reason why Mr. Song failed to detect lung cancer even though he took chest X-ray every year.
Sputum examination may not be able to detect tumor cells
Sputum examination is also an important test to detect lung tumor. Literally, it is an easy, non-invasive and painless test that can detect lesions in the lungs by simply coughing up a mouthful of sputum. The actual examination process and results are far less simple than one might think. Sputum examination has quite high requirements for specimen collection, not just coughing up a mouthful of sputum can meet the diagnostic requirements, it must be sputum coughed up from deep bronchial tubes after waking up early in the morning to meet the requirements. Lung cancer tissues can only be examined by sputum if they grow into the bronchial tubes and the shed cells are mixed in the sputum. Therefore, tumor cells may not be detected by only one or digital sputum examination.
White light bronchoscopy cannot see early submucosal lesions
Both of the above are indirect examination means. The introduction of white-light bronchoscopy has pushed the early diagnosis of lung cancer to a new level. It is one of the more clinically used diagnostic and screening work for lung cancer. With the help of it, doctors can directly see the lesions in the inner wall of bronchial lumen, and furthermore, they can do biopsy of local tissues and adjacent mediastinal lymph nodes. However, even such an advanced diagnostic equipment still has defects. If the tumor tissue does not break through the confines of the bronchial mucosa, but rather the submucosa, then the white light bronchoscope cannot see the early lesions under the mucosa. Some people may say, doesn’t the white light bronchoscope have the function of tissue biopsy? Wouldn’t it be sufficient to clamp the submucosal tissue for pathological examination? Such a suggestion is not actionable – the length of the bronchial tubes adds up to a lot, and if every single one of them were biopsied, the whole lung would become full of holes. Even then, it’s possible to miss areas where tumors are growing.
New technology allows early stage lung cancer to reveal itself
Even the most rigorous examination may miss the early lesions, so the “carpet search” may not be effective. This is when medical researchers naturally came up with this idea – can we make tumor tissues appear on their own? Through unremitting efforts, a self-fluorescence bronchoscope that allows early stage lung cancer to “announce itself” was introduced. The shape of this bronchoscope is the same as the ordinary white light bronchoscope, but the only difference is the light source used for irradiation. The former uses a monochromatic light with a wavelength of 442 nm. When this special light hits the bronchial mucosal epithelium, the submucosal tissue is stimulated to emit fluorescence, much like the principle of fluorescent lamps. Normal mucosal tissue emits a light green fluorescence, while if there is early tumor tissue under the mucosa, there is local edema and thickening that is difficult to recognize with the naked eye, and the fluorescence emitted becomes reddish brown. With such a significant difference, pathological biopsy can be performed on the suspicious area to detect the disease at an early stage.
The latest treatment technology at the Tenth Hospital
The introduction of fluorescence bronchoscopy has opened up a new way for early diagnosis of bronchial lung cancer, which is especially suitable for early central lung cancer screening and diagnosis for people with high risk factors for lung cancer, enabling many patients with early lung cancer previously missed by ordinary bronchoscopy to be diagnosed and treated in a timely manner. In fact, in the past decade, fluorescence bronchoscopy has been widely used in developed countries such as Europe, North America and Japan, which has significantly improved the detection rate of early cancer in the airway and played an important role in the screening and follow-up of high-risk lung cancer patients. However, due to the late start in China, the general public does not have enough awareness of this advanced technology.