EARLY DETECTION OF LUNG CANCER AND RISK FACTORS FOR DEVELOPMENT AND PROGRESS OF DISEASE

his research proposal is testing the hypothesis postulating that the new fluorescence endoscopy technology, combined with simultaneous spectral analysis will increase sensitivity of detecting of very early carcinoma, carcinoma in situ (CIS) and dysplastic lesions and early metastases in endobronchial mucosa while at the same significantly increasing fluorescence endoscopy specificity. The current fluorescence systems have increased sensitivity of the early lung cancers (e.g. from 25% to 90% for CIS) but at the expense of specificity (a drop from 90% to 60 - 66 %) resulting in a large number of unnecessary biopsies in a single bronchoscopy session. The biopsies will be analysed both by conventional and quantitative pathology to reduce subjective classifications of the early lesions. Patients with malignancy in oropharingeal area often develop primary malignancy in the lung. Therefore, in our project we are going to test our hypothesis starting that we could detect very early lung cancer in such patients with spectral endoscopy. For this reason we will include such patients in the study. At the same time we shall test for the presence of selected viral infectious that are believed to be responsible for rapid progression of malignancy. We shall measure the impact of the fibrinolytic enzyme system on prognosis and survival of lung cancer patients. The combined program should result in a better management of lung cancer patients including reduced mortality, longer survival, better quality of life and increased cost-effectiveness of treatment.