经支气管冷冻活检在非肿瘤性肺部疾病中的诊断率：一项回顾性病例系列研究
Diagnostic yield of transbronchial cryobiopsy in non-neoplastic lung disease: a retrospective case series.
作者信息
Griff Sergej, Schönfeld Nicolas, Ammenwerth Wilhelm, Blum Torsten-Gerriet, Grah Christian, Bauer Torsten T, Grüning Wolfram, Mairinger Thomas, Wurps Henrik
机构信息
Institute of Pathology, HELIOS Klinikum Emil von Behring, Walterhöferstr, 11, 14165 Berlin, Germany.
出版信息
BMC Pulm Med. 2014 Nov 3;14:171. doi: 10.1186/1471-2466-14-171.
BACKGROUND
Due to the small amount of alveolar tissue in transbronchial biopsy (TBB) by forceps, the diagnosis of diffuse, parenchymal lung diseases (DPLD) is inherently problematic, with an overall low yield. The use of cryotechnique in bronchoscopy, including TBB by cryoprobe, has revealed new opportunities in the endoscopical diagnosis of malignant and non-malignant lung diseases.
METHODS
To evaluate TBB by cryotechnique for non-neoplastic lung diseases, we analyzed 52 patients (mean age 63 ± 13 years) with unclear DPLD. These individuals underwent bronchoscopy with TBB by cryoprobe. Thereafter histopathological results were compared with the clinically evaluated diagnosis.
RESULTS
No major complications were seen. Mean specimen diameter in the histological biopsies was 6.9 ± 4.4 mm (Range 2 - 22 mm). A correlation between clinical and histopathological diagnoses was found in 79% of cases (41/52). In the case of UIP (usual interstitial pneumonia) pattern, the concordance was 10/15 (66%).
CONCLUSION
Based on these results TBB by cryotechnique would appear to be a safe and useful method that reveals new perspectives for the endoscopical diagnosis of DPLD.
背景
由于经支气管活检钳取的肺泡组织量少，弥漫性实质性肺疾病（DPLD）的诊断存在固有问题，总体诊断阳性率较低。在支气管镜检查中使用冷冻技术，包括经冷冻探头进行经支气管活检，为恶性和非恶性肺部疾病的内镜诊断带来了新机遇。
方法
为评估冷冻技术在非肿瘤性肺部疾病经支气管活检中的应用，我们分析了52例弥漫性实质性肺疾病诊断不明的患者（平均年龄63±13岁）。这些患者接受了经冷冻探头的经支气管活检支气管镜检查。之后将组织病理学结果与临床评估诊断进行比较。
结果
未观察到严重并发症。组织学活检标本的平均直径为6.9±4.4毫米（范围2 - 22毫米）。79%的病例（41/52）临床诊断与组织病理学诊断存在相关性。在寻常型间质性肺炎（UIP）模式下，一致性为10/15（66%）。
结论
基于这些结果，冷冻技术经支气管活检似乎是一种安全且有用的方法，为弥漫性实质性肺疾病的内镜诊断开辟了新视角。
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