ADVANCES IN FLEXIBLE BRONCHOSCOPY FOR EARLY DIAGNOSIS OF LUNG CANCER

Abstract

Lung cancer remains the leading cause of cancer-related death. In central airway lesions, flexible bronchoscopy (FB) is the diagnostic backbone, as it allows direct visualization, lesion localization, and sampling, while integrating new technologies such as autofluorescence bronchoscopy (AFB), narrow-band imaging (NBI), endobronchial ultrasound (EBUS), optical coherence tomography (OCT), electromagnetic/CBCT-guided navigation bronchoscopy (ENB, CBCT), robotic bronchoscopy, and “real-time pathology” techniques such as confocal laser endomicroscopy (CLE). Over the past 5–7 years, evidence shows these technologies significantly enhance sensitivity/early detection, increase diagnostic yield for small peripheral nodules, reduce complications compared with transthoracic biopsy, and open the era of artificial intelligence (AI) for lesion recognition and procedural training. This article summarizes key advances, clinical impact, limitations, and implementation prospects in Vietnam.