Evaluating the diagnostic and prognostic role of bronchoscopy combined with brush cytology in peripheral lung cancer

This study aimed to evaluate the diagnostic performance of bronchoscopy combined with brush cytology for peripheral lung cancer and to investigate its association with patient prognosis. A total of 269 patients with peripheral pulmonary nodules who were diagnosed and treated at our hospital between February 2020 and January 2021 were enrolled. All patients underwent bronchoscopy combined with brush-based liquid cytology. Based on pathological findings, patients were classified into a benign lesion group (n = 98) and a peripheral lung cancer group (n = 171). All patients were followed up for 1 year and assigned to either the survival or deceased group according to clinical outcomes. The diagnostic efficacy of bronchoscopy, brush cytology, and their combination was compared. Additionally, the expression of hypoxia-inducible factor-1 alpha (HIF-1α ), messenger ribonucleic acid (mRNA ), glucose transporter 1 (GLUT1) mRNA , and lung-specific x protein ( LUNX ) mRNA was assessed, and its correlation with prognosis was analyzed. The positive expression rates of HIF-1α mRNA , GLUT1 mRNA , and LUNX mRNA were significantly higher in the lung cancer group than in the benign lesion group ( P < .05). Among the 171 pathologically confirmed lung cancer cases, brush cytology, bronchoscopy, and their combined application detected 128, 121, and 119 cases, respectively. Among the 98 benign lesions, 74, 79, and 86 cases were correctly identified by the 3 methods. The overall diagnostic accuracy of brush cytology, bronchoscopy, and their combination was 75.09%, 74.35%, and 76.21%, respectively. Sensitivity was 75.51%, 80.61%, and 87.76%, while specificity was 74.85%, 70.76%, and 69.59%, respectively. Receiver operating characteristic curve analysis showed the area under the curve values were 0.821, 0.758, and 0.755. Bronchoscopy combined with brush cytology demonstrates reliable accuracy and sensitivity in the diagnosis of peripheral lung cancer. Positive expression of HIF-1α mRNA , GLUT1 mRNA , and LUNX mRNA is associated with poor prognosis and may serve as valuable biomarkers for predicting clinical outcomes in patients with peripheral lung cancer.