Liu C P, Gu Y Y, Li S Y, Chen X B, Li L G, Jiang J J, Zhao J, Fu L, Li M S, Chen Z C
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Pathology Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510090, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2020 Mar 12;43(3):228-233. doi: 10.3760/cma.j.issn.1001-0939.2020.03.018.
To evaluate the value of transbronchial lung cryobiopsy (TBCB) in pathological diagnosis for diffuse lung disease. The clinicopathological data of 173 patients from the first affiliated hospital of Guangzhou medical university between Jaunary 2017 and June 2019 with transbronchial lung cryobiopsy of diffuse lung disease were retrospectively analyzed and summarized with review. Among 173 cases, TBCB and conventional transbronchial lung biopsy (TBLB) were performed in 54 patients. The size of biopsy samples and diagnostic yield were compared. Among 173 cases, the diagnostic yield was 85.54% (148/173) , 160 (92.49%) cases provided definite diagnosis and valuable pathological results, according to age, sex, occupation, past history, contact history, smoking history, laboratory serology and imaging findings. Among 160 cases, there were 72 cases of known etiology (45.00%), 27 cases of idiopathic interstitial pneumonia (16.88%), 7 cases of granulomatous lesions (4.38%) and 54 cases of other types (33.75%). With TBCB and TBLB in 54 patients, the specimens sizes of TBCB and TBLB were (3.3±1.3) mm(2) and (1.0±0.3) mm(2) respectively ('=12.67 0.01) . The diagnostic yields of TBCB and TBLB were 81.48% (44/54) and 42.59% (23/54) respectively (χ(2)=17.33, 0.01) . The diagnostic yields of TBCB and TBLB for interstitial lung diseases were 48.15% (26/54) and 5.56% (3/54) respectively (χ(2)=24.94, 0.01) . However, the diagnostic yields of TBCB and TBLB for the other diffuse lung disease except interstitial lung diseases were 33.33% (18/54) and 37.04% (20/54) respectively, with no significant difference (χ(2)=0.1624, 0.687). Compared with TBLB, TBCB has obvious advantages and application value in the diagnosis of diffuse pulmonary diseases, especially interstitial pulmonary diseases.
评估经支气管肺冷冻活检（TBCB）在弥漫性肺疾病病理诊断中的价值。回顾性分析并总结广州医科大学附属第一医院2017年1月至2019年6月173例行弥漫性肺疾病经支气管肺冷冻活检患者的临床病理资料。173例中，54例患者同时行TBCB和传统经支气管肺活检（TBLB），比较活检标本大小及诊断阳性率。173例中，诊断阳性率为85.54%（148/173），根据年龄、性别、职业、既往史、接触史、吸烟史、实验室血清学及影像学表现，160例（92.49%）获得明确诊断及有价值的病理结果。160例中，已知病因72例（45.00%），特发性间质性肺炎27例（16.88%），肉芽肿性病变7例（4.38%），其他类型54例（33.75%）。54例同时行TBCB和TBLB的患者中，TBCB与TBLB标本大小分别为（3.3±1.3）mm²和（1.0±0.3）mm²（t=12.67，P<0.01）。TBCB与TBLB诊断阳性率分别为81.48%（44/54）和42.59%（23/54）（χ²=17.33，P<0.01）。TBCB与TBLB对间质性肺疾病诊断阳性率分别为48.15%（26/54）和5.56%（3/54）（χ²=24.94，P<0.01）。而TBCB与TBLB对除间质性肺疾病外的其他弥漫性肺疾病诊断阳性率分别为33.33%（18/54）和37.04%（20/54），差异无统计学意义（χ²=0.1624，P=0.687）。与TBLB相比，TBCB在弥漫性肺疾病尤其是间质性肺疾病诊断中具有明显优势及应用价值。
