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日本经支气管肺冷冻活检的管理与应用

Management and utility of transbronchial lung cryobiopsy in Japan.

作者信息

Kuse Naoyuki, Inomata Minoru, Awano Nobuyasu, Yoshimura Hanako, Jo Tatsunori, Tone Mari, Moriya Atsuko, Bae Yuan, Kumasaka Toshio, Takemura Tamiko, Izumo Takehiro

机构信息

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8953, Japan.

Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8953, Japan.

出版信息

Respir Investig. 2019 May;57(3):245-251. doi: 10.1016/j.resinv.2018.12.011. Epub 2019 Feb 10.

Abstract

BACKGROUND

Transbronchial lung cryobiopsy (TBLC), which is transbronchial lung biopsy performed using a cryoprobe, has emerged as a new method for obtaining lung tissue specimens for diagnosing pulmonary diseases. TBLC has been widely performed, and many reports have documented its safety and feasibility in diagnosing pulmonary diseases such as lung cancer and diffuse parenchymal lung disease. However, to date, no reports have yet been published from Japan. Therefore, the purpose of this study was to describe our experience with TBLC in daily practice in Japan and compare it with those reported in previous studies from other countries. We also evaluated the efficacy and feasibility of TBLC.

METHODS

We retrospectively evaluated the clinical records of 50 consecutive patients who had undergone TBLC between November 2017 and May 2018 at the Japanese Red Cross Medical Center. Demographic data, procedure details, and the diagnostic yield were analyzed.

RESULTS

We analyzed the records of 50 patients who underwent diagnostic TBLC. Their median age was 71 years, and they included 34 men (68%). The median maximal diameter of the cryobiopsy specimens was 5.3 mm (range, 2.0-23.0 mm), and the median area of the cryobiopsy specimens was 15.5 mm (range, 3.0-136.5 mm). The rate of obtaining adequate specimens was 91%, and the pathological diagnostic yield was 76%. No complications were observed, except for one case of pneumonia.

CONCLUSIONS

This is the first report from Japan analyzing the efficacy and feasibility of TBLC in daily clinical practice. TBLC was considered efficacious, safe, and feasible for Japanese patients with various lung diseases.

摘要

背景

经支气管肺冷冻活检(TBLC),即使用冷冻探头进行的经支气管肺活检,已成为获取肺组织标本以诊断肺部疾病的一种新方法。TBLC已被广泛应用,许多报告记录了其在诊断肺癌和弥漫性实质性肺疾病等肺部疾病方面的安全性和可行性。然而,迄今为止,日本尚未发表相关报告。因此,本研究的目的是描述我们在日本日常临床实践中使用TBLC的经验,并与其他国家先前研究报告的经验进行比较。我们还评估了TBLC的有效性和可行性。

方法

我们回顾性评估了2017年11月至2018年5月期间在日本红十字会医疗中心连续接受TBLC的50例患者的临床记录。分析了人口统计学数据、操作细节和诊断率。

结果

我们分析了50例接受诊断性TBLC患者的记录。他们的中位年龄为71岁,其中包括34名男性(68%)。冷冻活检标本的中位最大直径为5.3毫米(范围为2.0 - 23.0毫米),冷冻活检标本的中位面积为15.5平方毫米(范围为3.0 - 136.5平方毫米)。获取足够标本的率为91%,病理诊断率为76%。除1例肺炎外,未观察到并发症。

结论

这是日本首份分析TBLC在日常临床实践中的有效性和可行性的报告。对于患有各种肺部疾病的日本患者,TBLC被认为是有效、安全且可行的。

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