Simon Mărioara, Simon Ioan, Tent Paul Andrei, Todea Doina Adina, Haranguș Antonia
"Leon Daniello" Clinical Hospital of Pulmonology, 400371 Cluj-Napoca, Romania.
Departament of Surgery, Iuliu Hațieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.
Medicina (Kaunas). 2021 Apr 19;57(4):393. doi: 10.3390/medicina57040393.
Optimizing the diagnosis of lung cancer represents a challenge, as well as a necessity, for improving the low survival of these patients. Flexible bronchoscopy with forceps biopsy is one of the key diagnostic procedures used for lung tumors. The small sample size and crush artifacts are several factors that can often limit access to a complete diagnosis, therefore leading to the need of repeating the bronchoscopy procedure or other invasive diagnostic methods. The bronchoscopic cryobiopsy is a recent technique that proved its utility in the diagnosis of both endobronchial and peripheral lung tumors. In comparison with conventional forceps biopsy, studies report a higher diagnostic yield and a superior quality of the collected samples for both the histopathological and the molecular diagnosis of lung cancer. This method shows promising results in sampling lung tissue, alone, or in conjunction with fluoroscopy or radial endobronchial ultrasound (r-EBUS). With a good safety and cost-benefit profile, this novel method has the potential to improve the diagnosis, and therefore the management of lung cancer patients. The objective of this narrative review is to provide a comprehensive review of the recent data regarding the advantages of cryobiopsy and r-EBUS in lung cancer diagnosis.
优化肺癌诊断对提高这类患者的低生存率而言既是一项挑战,也是一项必要举措。经钳夹活检的可弯曲支气管镜检查是用于肺部肿瘤的关键诊断程序之一。样本量小和挤压伪像等诸多因素常常会限制获得完整诊断的机会,进而导致需要重复进行支气管镜检查或采用其他侵入性诊断方法。支气管镜冷冻活检是一项新技术,已证明其在诊断支气管内和周围型肺部肿瘤方面的效用。与传统钳夹活检相比,研究报告称,对于肺癌的组织病理学和分子诊断,冷冻活检的诊断率更高,所采集样本的质量也更优。该方法在单独采集肺组织样本,或与荧光透视或径向支气管内超声(r-EBUS)联合使用时均显示出良好的效果。鉴于其良好的安全性和成本效益,这种新方法有潜力改善肺癌诊断,进而改善肺癌患者的治疗。本叙述性综述的目的是全面回顾有关冷冻活检和r-EBUS在肺癌诊断中的优势的最新数据。