{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:47:09Z","timestamp":1760244429203,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Beijing Municipal Science &amp; Technology Commission","award":["Z201100006820092"],"award-info":[{"award-number":["Z201100006820092"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>(1) Background: It has yet to be determined whether preoperative flexible bronchoscopy (FB) should be routinely performed in patients with peripheral lung cancer. The aim of this study was to construct a model to predict the probability of positive FB findings, which would help assess the necessity of preoperative FB. (2) Methods: A total of 380 consecutive patients with peripheral lung cancer who underwent preoperative FB were recruited for this study. A prediction model was developed through univariate and multivariate logistic regression, with predictors including gender, age, body mass index (BMI), smoking, history of chronic lung diseases, respiratory symptoms, lesion size, lesion type, lesion location in the bronchi, and lesion location in the lobe. The predictive performance of the model was evaluated by validation using 1000 iterations of bootstrap resampling. Model discrimination was assessed using the area under the receiver operating characteristics curve (AUC), and calibration was assessed using the Brier score and calibration plots. (3) Results: The model suggested that male patients with respiratory symptoms, decreased BMI, solid lesions, and lesions located in lower-order bronchi were more likely to have positive FB findings. The AUC and Brier score of the model for internal validation were 0.784 and 0.162, respectively. The calibration curve for the probability of positive FB findings showed convincing concordance between the predicted and actual results. (4) Conclusions: Our prediction model estimated the pretest probability of positive FB findings in patients with peripheral lung cancers. Males and patients with lower BMI, the presence of respiratory symptoms, larger lesions, solid lesions, and lesions located in lower-order bronchi were associated with increased positive FB findings. The use of our model can be of assistance when making clinical decisions about preoperative FB.<\/jats:p>","DOI":"10.3390\/curroncol30010025","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T07:33:33Z","timestamp":1672126413000},"page":"315-325","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of a Prediction Model for Positive Findings of Preoperative Flexible Bronchoscopy in Patients with Peripheral Lung Cancer"],"prefix":"10.3390","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3466-4695","authenticated-orcid":false,"given":"Dongyu","family":"Li","sequence":"first","affiliation":[{"name":"Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China"},{"name":"Yuncheng Central Hospital, Yuncheng 044000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaishan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaolei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongbing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siqing","family":"Yao","sequence":"additional","affiliation":[{"name":"Yuncheng Central Hospital, Yuncheng 044000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Yuncheng Central Hospital, Yuncheng 044000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0272-5231(03)00065-0","article-title":"Bronchoscopy and Needle Biopsy Techniques for Diagnosis and Staging of Lung Cancer","volume":"23","author":"Mazzone","year":"2002","journal-title":"Clin. Chest Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1055\/s-0030-1255961","article-title":"Prevention, Diagnosis, Therapy, and Follow-up of Lung Cancer","volume":"65","author":"Goeckenjan","year":"2011","journal-title":"Pneumologie"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.ejcts.2008.11.027","article-title":"Use of N-Acetylcysteine to Reduce Post-Cardiothoracic Surgery Complications: A Meta-Analysis","volume":"35","author":"Baker","year":"2009","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Odor, P.M., Bampoe, S., Gilhooly, D., Creagh-Brown, B., and Moonesinghe, S.R. (2020). Perioperative Interventions for Prevention of Postoperative Pulmonary Complications: Systematic Review and Meta-Analysis. BMJ, 368.","DOI":"10.1136\/bmj.m540"},{"key":"ref_6","first-page":"309","article-title":"Airways Colonizations in Patients Undergoing Lung Cancer Surgery","volume":"40","author":"Rolain","year":"2011","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_7","unstructured":"(2022, March 15). NCCN Guidelines: Non-Small Cell Lung Cancer, Version 2. Available online: http:\/\/www.nccn.org\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"iv1","DOI":"10.1093\/annonc\/mdx222","article-title":"Early and Locally Advanced Non-Small-Cell Lung Cancer (NSCLC): ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up","volume":"28","author":"Postmus","year":"2017","journal-title":"Ann. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e93S","DOI":"10.1378\/chest.12-2351","article-title":"Evaluation of Individuals with Pulmonary Nodules: When Is It Lung Cancer?","volume":"143","author":"Gould","year":"2013","journal-title":"Chest"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Jhun, B.W., Um, S.-W., Suh, G.Y., Chung, M.P., Kim, H., Kwon, O.J., Lee, K.S., Han, J., and Kim, J. (2015). Preoperative Flexible Bronchoscopy in Patients with Persistent Ground-Glass Nodule. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0121250"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.21037\/tlcr-20-1122","article-title":"Is Flexible Bronchoscopy Necessary in the Preoperative Workup of Patients with Peripheral CT1N0 Subsolid Lung Cancer?\u2014A Prospective Multi-Center Cohort Study","volume":"10","author":"Ye","year":"2021","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1378\/chest.12-0135","article-title":"Bronchoscopy for the Solitary Pulmonary Nodule","volume":"142","author":"Silvestri","year":"2012","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1378\/chest.104.1.94","article-title":"The Role of Staging Bronchoscopy in the Preoperative Assessment of a Solitary Pulmonary Nodule","volume":"104","author":"Goldberg","year":"1993","journal-title":"Chest"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1055\/s-0034-1377062","article-title":"Value of Flexible Bronchoscopy for the Preoperative Assessment of NSCLC Diagnosed Using Percutaneous Core Needle Biopsy","volume":"62","author":"Jo","year":"2014","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1378\/chest.104.4.1021","article-title":"The Utility of Fiberoptic Bronchoscopy in the Evaluation of the Solitary Pulmonary Nodule","volume":"104","author":"Torrington","year":"1993","journal-title":"Chest"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jtcvs.2015.02.060","article-title":"Is Bronchoscopy Necessary in the Preoperative Workup of a Solitary Pulmonary Nodule?","volume":"150","author":"Zhang","year":"2015","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e142S","DOI":"10.1378\/chest.12-2353","article-title":"Establishing the Diagnosis of Lung Cancer","volume":"143","author":"Rivera","year":"2013","journal-title":"Chest"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/j.jtho.2016.03.025","article-title":"The IASLC Lung Cancer Staging Project: Proposals for Coding T Categories for Subsolid Nodules and Assessment of Tumor Size in Part-Solid Tumors in the Forthcoming Eighth Edition of the TNM Classification of Lung Cancer","volume":"11","author":"Travis","year":"2016","journal-title":"J. Thorac. Oncol."},{"key":"ref_19","first-page":"169","article-title":"Differing Histopathology and Prognosis in Pulmonary Adenocarcinoma at Central and Peripheral Locations","volume":"8","author":"Moon","year":"2016","journal-title":"J. Thorac. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.athoracsur.2004.01.029","article-title":"Clinicopathologic Features of Peripheral Squamous Cell Carcinoma of the Lung","volume":"78","author":"Sakurai","year":"2004","journal-title":"Ann. Thorac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1183\/09031936.00018612","article-title":"Value of Flexible Bronchoscopy in the Pre-Operative Work-up of Solitary Pulmonary Nodules","volume":"41","author":"Schwarz","year":"2013","journal-title":"Eur. Respir. J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ernst, A., and Herth, F.J.F. (2017). Flexible Bronchoscopy: Indications, Contraindications, and Consent. Introduction to Bronchoscopy, Cambridge University Press.","DOI":"10.1017\/9781316084182"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3348\/kjr.2002.3.4.229","article-title":"Superficial Endobronchial Lung Cancer: Radiologic-Pathologic Correlation","volume":"3","author":"Han","year":"2002","journal-title":"Korean J. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.lungcan.2007.04.009","article-title":"Dual Digital Video-Autofluorescence Imaging for Detection of Pre-Neoplastic Lesions","volume":"58","author":"Lee","year":"2007","journal-title":"Lung Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"201","DOI":"10.4149\/neo_2012_026","article-title":"Fiber-Optic Bronchoscope and Detection of Lung Cancer: A Five Year Study","volume":"59","author":"Gao","year":"2012","journal-title":"Neoplasma"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.critrevonc.2012.06.009","article-title":"Squamous-Cell Carcinoma of the Lungs: Is It Really so Different?","volume":"84","author":"Sereno","year":"2012","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1183\/09031936.02.00236402","article-title":"Bronchial Bacterial Colonization in Patients with Resectable Lung Carcinoma","volume":"19","author":"Ioanas","year":"2002","journal-title":"Eur. Respir. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/1097-0142(1967)20:5<687::AID-CNCR2820200521>3.0.CO;2-K","article-title":"Transbronchial Biopsy Smear for Diagnosis of Peripheral Pulmonary Carcinomas","volume":"20","author":"Tsuboi","year":"1967","journal-title":"Cancer"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/1\/25\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:51:23Z","timestamp":1760147483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/1\/25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,26]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["curroncol30010025"],"URL":"https:\/\/doi.org\/10.3390\/curroncol30010025","relation":{},"ISSN":["1718-7729"],"issn-type":[{"type":"electronic","value":"1718-7729"}],"subject":[],"published":{"date-parts":[[2022,12,26]]}}}