Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Hospital Bethanien Solingen, Solingen, Germany
Institute for Pathology and Neuropathology, University Hospital Essen, Essen, Germany.
Thorax. 2019 Jul;74(7):711-714. doi: 10.1136/thoraxjnl-2018-212095. Epub 2019 Mar 9.
Sixty-one subjects with fibrosing interstitial lung disease were prospectively analysed to determine the efficacy of transbronchial cryobiopsy (CryoTBB) and the effect of procedural modifications which were introduced after an interim analysis of the first 19 subjects. The modifications significantly reduced complication rates from 84% to 14% (p<0.001). 30-day-mortality was 2%. The algorithm with initial CryoTBB and surgical lung biopsy (SLB) as optional step-up procedure was feasible. CryoTBB led to a confident diagnosis in 46/61 subjects (75%). Only 21% out of all subjects were forwarded for SLB. As the modified CryoTBB reduced but not eliminated the risk of severe complications, tissue sampling should be limited to patients where confident diagnosis enables life prolonging therapy. Trial registration number: NCT01714518.
61 例纤维性间质性肺病患者前瞻性分析，以确定经支气管冷冻活检（CryoTBB）的疗效，以及在对前 19 例患者进行中期分析后引入的程序修改的效果。修改后，并发症发生率从 84%显著降低至 14%（p<0.001）。30 天死亡率为 2%。初始采用 CryoTBB 和外科肺活检（SLB）作为可选升级程序的方案是可行的。CryoTBB 使 61 例患者中的 46 例（75%）得到了明确诊断。所有患者中仅有 21%需要进行 SLB。由于改良的 CryoTBB 降低了但并未消除严重并发症的风险，因此组织取样应仅限于能进行延长生命治疗的患者。临床试验注册号：NCT01714518。
