Contributions of bronchoscopic microsampling in the supplemental diagnosis of small peripheral lung carcinoma Masazumi Watanabe, MD, PhD, Akitoshi Ishizaka,

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Contributions of bronchoscopic microsampling in the supplemental diagnosis of small peripheral lung carcinoma Masazumi Watanabe, MD, PhD, Akitoshi Ishizaka, MD, PhD, Eiji Ikeda, MD, PhD, Akira Ohashi, PhD, Koichi Kobayashi, MD, PhD The Annals of Thoracic Surgery Volume 76, Issue 5, Pages 1668-1672 (November 2003) DOI: 10.1016/S0003-4975(03)01015-4

Fig 1 Illustration of the bronchoscopic microsampling probe. The Annals of Thoracic Surgery 2003 76, 1668-1672DOI: (10.1016/S0003-4975(03)01015-4)

Fig 2 Bronchoscopic microsampling procedure under fluoroscopy. The arrow indicates the radiopaque marker. The Annals of Thoracic Surgery 2003 76, 1668-1672DOI: (10.1016/S0003-4975(03)01015-4)

Fig 3 Cytokeratin fragment 19 in epithelial lining fluid. Epithelial lining fluid weight–uncorrected values are correlated with weight–corrected values (p < 0.001). The Annals of Thoracic Surgery 2003 76, 1668-1672DOI: (10.1016/S0003-4975(03)01015-4)

Fig 4 (A) Cytokeratin fragment 19 values in epithelial lining fluid. (B) Carcinoembryonic antigen values. (C) Sialyl SSEA-1 values. The box-whisker plots show the 25th and 75th percentiles, the median (horizontal line within the box), and the 10th and 90th percentiles (whiskers). *p < 0.05, **p < 0.01 (cancerous tissue group versus other groups). The Annals of Thoracic Surgery 2003 76, 1668-1672DOI: (10.1016/S0003-4975(03)01015-4)

Fig 5 Receiver operating characteristic curves for cytokeratin fragment 19 (CYFRA), carcinoembryonic antigen (CEA), and sialyl SSEA-1 (SLX). The areas under the curve values were 0.933 for cytokeratin fragment 19, 0.753 for carcinoembryonic antigen, and 0.704 for sialyl SSEA-1. Cytokeratin fragment 19 versus carcinoembryonic antigen, p = 0.0343; cytokeratin fragment 19 versus sialyl SSEA-1, p = 0.0197; carcinoembryonic antigen versus sialyl SSEA-1, p = 0.6331. Cytokeratin fragment 19 was the most reliable marker. (FPR = false-positive rate; TPR = true-positive rate.) The Annals of Thoracic Surgery 2003 76, 1668-1672DOI: (10.1016/S0003-4975(03)01015-4)

Fig 6 Microscopic immunohistochemical staining of cytokeratin fragment 19. The expression of cytokeratin fragment 19 was prominent in tumor tissue, weak in tissue near the tumor (A and B), and absent in normal lung tissue (C and D). Arrowheads show cancer cells and arrows show cells at marginal region. Bar in A and C, 100 μm; B and D, 50 μm. The Annals of Thoracic Surgery 2003 76, 1668-1672DOI: (10.1016/S0003-4975(03)01015-4)