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Diagnostic concordance between bronchoscopy and histopathology in patients with pulmonary neoplasms

Durán Acuña, Ricardo , Araque, Carolina , Chaves, Juan José , Jiménez, Julián , Polo, Fernando , Parra Medina, Rafael





2019, Number 2

2019; 78 (2)






ABSTRACT

Background: Lung cancer is one of the leading causes of death worldwide, it is generally discovered in advanced stages, constituting a poor prognosis, which this last one has an improvement with early diagnosis and timely management. The aim of this study is evaluate the concordance between the fibrobronchoscopic and histopathological findings in patients with pulmonary neoplasias, in order to perform complementary studies of immunohistochemistry or molecular tests to suspected cases of malignancy in the fibrobronchoscopic. Materials and methods: A diagnostic agreement study was carried out, including patients older than 18 years with a diagnosis of pulmonary neoplasms. Absolute agreement and agreement beyond chance were estimated using Cohen’s Kappa concordance statistic. Results: 369 cases were included in the study, of which 207 patients (56.1%) were male. The median of age was 58 years (IQR 23). The concordance of the fibrobronchoscopic and histopathological diagnosis of pulmonary neoplasia was moderate with a positive Kappa index of 0.605 (95% CI of 0.496-0.715). The agreement rate was 89%. The adenocarcinoma was the tumor that showed the least agreement between the two tests. Conclusion: The present study showed a moderate concordance between the fibrobronchoscopic and histopathological findings, with an agreement rate of 89%. These findings confirm that the suspicion in endoscopy is fundamental to guide the diagnosis and request preliminary tests for an appropriate and timely histological study.

KEYWORDS

Pulmonary neoplasia, cancer, fibrobronchoscopy, biopsy, diagnostic concordance.

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2019, Number 2

2019; 78 (2)