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传统活检钳或热活检:两种方法诊断支气管内病变的比较研究

Conventional forceps or hot biopsy: comparative study of two methods in diagnosis of endobronchial lesions.

作者信息

Jabbari Hamidreza, Fakhri Mohammad, Lotfaliani Mojtaba, Kiani Arda

机构信息

Tracheal Diseases Research Center, Notional Research Institute of TuberculosisandLung Disease, Shahid Beheshti University of Medical Sciences, Tehron, Iran.

出版信息

Pneumologia. 2013 Mar-Jun;62(2):80-5.

Abstract

BACKGROUND

It is suggested that hot electrocoagulation-enabled forceps (hot biopsy) may reduce hemorrhage risk after the biopsy in endobronchial tumors. The main concern in this method is possible reduction of the specimen's quality.

OBJECTIVES

To compare the procedure related hemorrhage with hot biopsy and conventional forceps biopsy and the diagnostic quality of the obtained specimens with either technique.

METHODS

In this prospective study, assessment of the biopsy samples and quantity of hemorrhage were done in a blind fashion. At first, for each patient a definite clinical diagnosis was made based on pathologic examination of all available samples, clinical data, and imaging findings. Then, second pathologist reviewed all samples to evaluate the quality of the samples.

RESULTS

A total of 36 patients with endobronchial lesions were included in this study. Definite diagnosis was made in 83% of the patients. Diagnostic yield of the two methods were not statistically different, while the mean hemorrhage grades of all hot biopsy protocols were significantly lower as compared to that of conventional biopsy (p=0.003, p<0.001 and p<0.001 for 10,20and40 voltages respectively). No significant difference was detected between the qualities of specimens obtained by hot biopsy methods in comparison with conventional biopsy (p>0.05 for all three voltages).

CONCLUSIONS

Hot biopsy can be a valuable alternative to forceps biopsy in evaluating endobronchial lesions.

摘要

背景

有研究表明,热凝活检钳(热活检)可能会降低支气管内肿瘤活检后的出血风险。该方法的主要问题在于可能会降低标本质量。

目的

比较热活检与传统活检钳活检的操作相关出血情况以及两种技术所获标本的诊断质量。

方法

在这项前瞻性研究中,以盲法对活检样本和出血量进行评估。首先,根据所有可用样本的病理检查、临床数据和影像学检查结果,对每位患者做出明确的临床诊断。然后,由第二位病理学家对所有样本进行复查,以评估样本质量。

结果

本研究共纳入36例支气管内病变患者。83%的患者得到了明确诊断。两种方法的诊断率无统计学差异,而所有热活检方案的平均出血分级均显著低于传统活检(10伏、20伏和40伏时的p值分别为0.003、<0.001和<0.001)。与传统活检相比,热活检方法所获标本的质量无显著差异(三种电压下的p值均>0.05)。

结论

在评估支气管内病变时,热活检可成为活检钳活检的一种有价值的替代方法。

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