Clinco pathological study of bronchial biopsies: A prospective study from a tertiary care hospital in Kashmir valley

Background: Lung cancer is currently the most frequently diagnosed major cancer in the world and the most common cause of cancer mortality worldwide. It comprises about 17% of the total new cancer cases in males and 23% of the total cancer deaths. The incidence is increasing dramatically in women and lung cancer has surpassed breast cancer as a leading cause of cancer death in women. To combat the disease successfully, lung cancer should be diagnosed at earliest possible stage preferably before the lesion has reached the stage of a visible and palpable tumor. Aim: To study the role of bronchial biopsies in diagnosis of different lung lesions, study the correlation between various histopathological lesions of lung with age and sex of patients and to find correlation between clinical presentation and nature of lung lesions. Materials and Methods: Two year prospective study conducted in the Department of Pathology Government Medical college Srinagar, from July 2013 to August2015.The study was conducted on 130 bronchial biopsies including transbronchial biopsies (TBB)). The biopsies so obtained have been fixed in 10% buffered formalin. And the specimen of tissue have been processed, then sections of 4-5 micron thickness have been prepared and stained with routine hematoxylin and eosin. Results: In our study conducted on 130 bronchial biopsies(including TBB), the results are summarized as under ,Out of a total of 130 clinically suspected cases of lung cancer tumor was found in 83 cases(83/130) by biopsy. The overall mean age of patients of primary lung cancer was 63.12 years with maximum number of cases seen between 61-70years.The mean age for men was 62.23 years and for females, it was 59.34 years. The peak incidence of the disease was seen in age group of 61-70 years which constituted 32.03% percent of all cases. Minimum age was 35year old male diagnosed as well differentiated squamous cell carcinoma, maximum age seen was 90 years. Males were more common affected by lung tumors than females with a male to female ratio was 1.88:1.Tumor was found in the right side of lung in 58 cases (69.87%) and in the left side of lung in 25 cases (30.12%). The smoker to non-smoker ratio was 1.4:1.The two main histological sub-types of lung cancer among smokers was squamous cell carcinoma (65.06%) and Adenocarcinoma (19.27%). Diagnostic yield for endobronchial biopsy was 63.84% (83/130cases), Squamous cell carcinoma (65.25%) and small cell carcinoma (12.4%) were more associated with endoscopically visible lesions than other cell types. Adenocarcinoma and (54%) and large cell carcinoma (57% were more associated with peripheral lesions. Squamous cell carcinoma, Adenocarcinoma, small cell carcinoma are more common in males whereas Pleomorphic anaplastic carcinoma was seen exclusively in females. Conclusion: The bronchial biopsies permits exact diagnosis of specific entity histologically including infectious pathology at earliest stage. Thus in the present study yield of diagnosis was highest with the bronchoscopic biopsies and in maximum number of cases, specific histopathological diagnosis was made on biopsies only.