Sehgal Inderpaul S, Bal Amanjit, Dhooria Sahajal, Gupta Nalini, Ram Babu, Aggarwal Ashutosh N, Behera Digambar, Agarwal Ritesh
Departments of Pulmonary Medicine.
Histopathology.
J Bronchology Interv Pulmonol. 2018 Jan;25(1):31-36. doi: 10.1097/LBR.0000000000000439.
Transbronchial lung biopsy (TBLB) is an important bronchoscopic procedure used in the diagnosis of sarcoidosis. Only a few studies have evaluated determinants associated with successful diagnostic yield of TBLB. Herein, we evaluate the factors predicting successful yield of TBLB in subjects with sarcoidosis.
Consecutive subjects with a clinical suspicion of sarcoidosis who underwent TBLB were enrolled. We evaluated the association between symptoms, spirometric lung function, radiologic stage of sarcoidosis, number of specimens, presence of floating biopsies, number of alveoli, and successful diagnostic yield (presence of granuloma) on TBLB.
Of the 223 subjects, sarcoidosis was diagnosed in 209 [mean (SD) age, 43.9 (12.6) y; 50.7% men] individuals. A total of 1021 TBLB specimens were obtained. Granulomas were demonstrated in 123 (58.9%) subjects on TBLB. On a multivariate analysis, there was no association between successful diagnostic yield and the presence of dyspnea, spirometric lung function, radiologic stage of sarcoidosis, presence of floating biopsies, presence of at least 50 alveoli, or crush artifacts during histopathologic examination. Complications were encountered in 25 (11.9%) subjects. There were no deaths.
TBLB is a reasonably safe procedure with a good diagnostic yield. The present study did not identify any predictors associated with successful diagnostic yield of TBLB in sarcoidosis.
经支气管肺活检（TBLB）是用于结节病诊断的一项重要支气管镜检查程序。仅有少数研究评估了与TBLB诊断成功率相关的决定因素。在此，我们评估结节病患者中预测TBLB诊断成功的因素。
纳入连续接受TBLB且临床怀疑结节病的患者。我们评估了症状、肺功能仪测定的肺功能、结节病的放射学分期、标本数量、漂浮活检的存在情况、肺泡数量以及TBLB诊断成功率（肉芽肿的存在情况）之间的关联。
223例患者中，209例[平均（标准差）年龄，43.9（12.6）岁；50.7%为男性]被诊断为结节病。共获取1021份TBLB标本。TBLB检查发现123例（58.9%）患者存在肉芽肿。多因素分析显示，诊断成功率与呼吸困难的存在、肺功能仪测定的肺功能、结节病的放射学分期、漂浮活检的存在、至少50个肺泡的存在或组织病理学检查时的挤压伪像之间无关联。25例（11.9%）患者出现并发症。无死亡病例。
TBLB是一种相当安全的检查程序，诊断成功率良好。本研究未发现与结节病患者TBLB诊断成功相关的任何预测因素。
