When a suspicious lesion shows up in the lungs on a CT scan, doctors are primarily concerned with knowing whether it is cancerous. A specialist passes a long, thin bronchoscope in the airway in the hope of grabbing a few cells of the lesions to be examined under a microscope.
Unfortunately, sometimes the lesions or nodules are deep in the small branches of the lungs and out of reach of the bronchoscope.
Other times, the results are inconclusive.
That leaves two other methods to determine whether the abnormality is cancerous: inserting a needle through the chest wall and into the tumor, or surgically opening a patient’s chest to find it and remove it if necessary.
The procedure for inserting a needle through the chest carries a 15% risk of collapsing a lung as well as an infection. The procedure of surgically opening a patient’s chest requires general anesthesia and results in the loss of lung tissue. Bother are inpatient procedures that carry the cost and other risks of hospitalizations. In about 1/3 of surgeries, the growth ends up being benign, essentially meaning that the surgery was unnecessary.
A new study published in the New England Journal of Medicine asserts that there is a much less invasive way of determining whether a growth is malignant.
Researchers at Boston University have discovered that the thin epithelial cells that line the entire airway show changes which indicate whether a growth is malignant. Researchers believe that with small brushes on the bronchoscope they can take some of those cells and reach a conclusion by using genomic testing.
The study found that the tests were about 97% accurate on 639 patients. A private company has purchased the technology and is making it available to hospitals across the country.
Although lung cancer usually develops deep in the lung, all the cells that line the airway are exposed and have changes in their genome.
The next question is whether those changes might be detected early enough to predict and prevent lung cancer.