Hernández-González Fernanda, Lucena Carmen M, Ramírez José, Sánchez Marcelo, Jimenez María José, Xaubet Antoni, Sellares Jacobo, Agustí Carlos
Servicio de Neumología y Alergia Respiratoria, Institut del Tòrax, Hospital Clínic, Barcelona, España.
Servicio de Anatomía Patológica, Hospital Clínic, Barcelona, España.
Arch Bronconeumol. 2015 Jun;51(6):261-7. doi: 10.1016/j.arbres.2014.09.009. Epub 2014 Nov 3.
Assessment of patients with suspected interstitial lung disease (ILD) includes surgical lung biopsy (SLB) when clinical and radiological data are inconclusive. However, cryobiopsy is acquiring an important role in the ILD diagnostic process. The objective of this study was to evaluate the diagnostic yield, safety and economic costs of the systematic use of cryobiopsy in the assessment of patients with suspected ILD.
This was a retrospective observational study of patients who had undergone transbronchial cryobiopsy for evaluation of ILD from January 2011 to January 2014. The procedures were performed with a video bronchoscope using a cryoprobe for the collection of lung parenchyma specimens, which were analyzed by pathologists. Diagnostic yield, complications and economic costs of this technique were analyzed.
Criobiopsy specimens from a total of 33 patients were included. A specific diagnosis was obtained in 26, producing a diagnostic yield of 79%. In 5 patients, SLB was required for a histopathological confirmation of disease, but the procedure could not be performed in 4, due to severe comorbidities. The most frequent complications were pneumothorax (12%) and gradei (9%) or gradeii (21%) bleeding. There were no life-threatening complications. The systematic use of cryobiopsy saved up to €59,846.
Cryobiopsy is a safe and potentially useful technique in the diagnostic assessment of patients with ILD. Furthermore, the systematic use of cryobiopsy has an important economic impact.
对于疑似间质性肺疾病（ILD）的患者，当临床和放射学数据不明确时，评估方法包括外科肺活检（SLB）。然而，冷冻活检在ILD诊断过程中正发挥着重要作用。本研究的目的是评估在疑似ILD患者评估中系统使用冷冻活检的诊断率、安全性和经济成本。
这是一项对2011年1月至2014年1月期间因评估ILD而接受经支气管冷冻活检的患者进行的回顾性观察研究。使用视频支气管镜和冷冻探头进行操作以采集肺实质标本，由病理学家进行分析。分析了该技术的诊断率、并发症和经济成本。
共纳入33例患者的冷冻活检标本。26例获得了明确诊断，诊断率为79%。5例患者需要进行SLB以进行疾病的组织病理学确诊，但4例因严重合并症无法进行该操作。最常见的并发症是气胸（12%）和Ⅰ级（9%）或Ⅱ级（21%）出血。没有危及生命的并发症。系统使用冷冻活检节省了高达59,846欧元。
冷冻活检在ILD患者的诊断评估中是一种安全且可能有用的技术。此外，系统使用冷冻活检具有重要的经济影响。
