Diagnostic endoscopique des lésions précoces

The diagnosis of precancerous lesions of the bronchial tree remains a challenge for the chest physicians. In the last 20 years, the development of autofluorescence-based techniques greatly impacted the detection of precancerous lesions compared with white light endoscopy. New techniques have been recently developed to get over the limitations of autofluorescence, allowing the lung exploration both distally and at the microscopic level in vivo. These methods include autofluorescence videoendoscopy, narrow band imaging (NBI), endobronchial ultrasonography (EBUS), optical coherence tomography (OCT) and probe based confocal laser endomicroscopy (MCFF). The histopathologic analysis is still currently the gold standard, however these new techniques could allow optical biopsies, then improving the diagnosis and the therapeutic management.