Franke Karl-Josef, Linzenbold Walter, Nuessle Daniela, Enderle Markus, Boesmueller Hans, Nilius Georg, Hetzel Jürgen
Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Witten/Herdecke University, Hagen, Germany.
Respiration. 2016;91(3):228-34. doi: 10.1159/000443990. Epub 2016 Feb 23.
Transbronchial cryobiopsy (TBCB) is a minimally invasive procedure to establish a diagnosis of interstitial lung disease though with the disadvantage that samples have to be extracted together with the bronchoscope.
The aim of the present study was to evaluate the feasibility of a new cryoprobe with which biopsy samples can be obtained through the working channel of the flexible bronchoscope.
The feasibility of obtaining transbronchial specimens with TBCB was tested and the technique was compared to transbronchial forceps biopsy (TBFB) in a prospectively randomized ex vivo animal study using a standard flexible bronchoscopy technique. The rate of successful biopsies and the duration of the sampling procedure were recorded for both methods. Size and quality of the biopsies were histologically evaluated and measured.
Biopsy samples could be obtained in 93.3% of TBCB and in 79.0% of TBFB procedures (p = 0.182). Sampling procedure time did not differ in any clinically relevant manner between the two methods. The mean specimen area of TBCB samples was significantly higher compared to that of TBFB samples (8.08 ± 5.80 vs. 2.61 ± 2.14 mm2; p < 0.0001). TBCB specimens showed less artifacts and a significantly higher percentage of alveolar tissue (53.57 vs. 25.42%; p = 0.0285) than TBFB specimens.
It is feasible to retrieve TBCB samples of good quality and size with the new mini cryoprobe through the working channel of the bronchoscope, while the bronchoscope remains within the central airways throughout the whole procedure. Further studies are necessary to evaluate the safety and efficacy in an in vivo setting.
经支气管冷冻活检（TBCB）是一种用于诊断间质性肺疾病的微创检查方法，但其缺点是样本必须与支气管镜一起取出。
本研究旨在评估一种新型冷冻探头的可行性，该探头可通过可弯曲支气管镜的工作通道获取活检样本。
在一项前瞻性随机离体动物研究中，采用标准的可弯曲支气管镜技术，测试了通过TBCB获取经支气管标本的可行性，并将该技术与经支气管钳取活检（TBFB）进行比较。记录两种方法的活检成功率和采样过程持续时间。对活检样本的大小和质量进行组织学评估和测量。
TBCB方法的活检样本获取成功率为93.3%，TBFB方法为79.0%（p = 0.182）。两种方法的采样过程时间在临床上无显著差异。TBCB样本的平均标本面积显著高于TBFB样本（8.08 ± 5.80 vs. 2.61 ± 2.14 mm²；p < 0.0001）。与TBFB样本相比，TBCB标本的伪像更少，肺泡组织百分比显著更高（53.57% vs. 25.42%；p = 0.0285）。
使用新型微型冷冻探头通过支气管镜的工作通道获取高质量和足够大小的TBCB样本是可行的，且在整个过程中支气管镜可始终保持在中央气道内。有必要进行进一步研究以评估其在体内环境中的安全性和有效性。
