Correlation Analysis Of Bronchoscopy Visualisation To Results Of Fungal Cultures In Lung Cancer

Abstract

Background: Fungal colonization is common as a secondary infection in lung cancer; currently it is often neglected due to similar clinical characteristics. Pulmonary mycosis impacts patient survival and quality of life. Bronchoscopy provides diagnostic benefits by enabling the direct visualization of suspicious lesions. Damage to the bronchial epithelium caused by cancer results in long-lasting inflammation, which makes it easier for fungi to stick, invade, and worsen the infection.

Methods:This observational analytic study used a cross-sectional design with 52 lung cancer patients that had bronchoscopy at Arifin Achmad General Hospital, Pekanbaru, from August 2024 to January 2025. Samples were chosen by consecutive sampling methods. We assessed the correlation between bronchoscopic visual findings and positive fungal cultures in lung cancer cases.

Result: The positive rate of fungal cultures was 76.9% and was significantly correlated with a high Brinkman Index smoking status (p=0.000), a history of COPD (p=0.046), and the use of bronchodilators with/without ICS (p=0.046). Candida sp. (61.5%) and Aspergillus species (9.6%) are the primary fungal types identified in lung cancer. The finding of irregular mucosa and hyperemic and infiltrative stenosis (53.8%) is the main finding in bronchoscopy and is significantly associated with positive fungal cultures (p=0.000). Infiltrative stenosis shows positivity for all fungal species, especially Candida sp. and Aspergillus sp. (p=0.015). Candida sp. isolates tend to manifest in orifices obscured by mass, while Aspergillus sp. tends to show up in cases of decompression stenosis.

Conclusion: A significant correlation exists between bronchoscopy visualization and the positivity of fungal cultures in lung cancer. Irregular mucosa, hyperaemia, and infiltrative stenosis show a high incidence in bronchoscopy visualization and have a significant correlation with the presence of all types of fungal infections in lung cancer.