Pre-neoplastic bronchial lesions: possibilities of diagnosis and chemo-prevention

Iulian Popescu

Secţia clinică de Radio-biologie Spitalul Clinic Fundeni Bucuresti

Early diagnosis of pulmonary cancer is crucial in the fight against this disease. Pre-neoplastic bronchial lesions are the first stage in the evolution towards invasive cancers. This paper describes histological patterns of these pre-neoplastic bronchial lesions, as well as early, intermediate and late molecular disturbancies associated with this condition. The ways to early identification of these lesions are:

a) bronchoscopy with laser-induced auto-fluorescence guided through Optical Coherence Tomography, which is able to identify celular and extracelular structures, from the celular surface or beneath it;

b) PET-CT which identifies lesions over 6 mm;

c) bio-markers: the sensitivity of the test is 60-70%; the positive predictive value is higher when these markers are taken together. p53 and p16-INK4A genes seem to have the higher predictive value.

Identification of these disturbancies leads to improved possibilities of chemo-prevention.

Contact: popdociul@yahoo.com