经支气管冷冻活检作为间质性肺疾病诊断的首选方法的单中心经验。
Single-centre experience of transbronchial cryobiopsy as a first choice method for the diagnosis of interstitial lung disease.
作者信息
Rivière Frédéric, Cazes Aurélie, Bylicki Olivier, Le Floch Hervé, Gaspard Wanda, Cornetto Marie Alice, Charton France, Margery Jacques, Grassin Frédéric
机构信息
Respiratory Department, Percy Military Teaching Hospital, 101 Avenue Henri Barbusse, 92140 Clamart, France.
Anatomopathological Department, Bichat Teaching Hospital, Paris, France.
出版信息
Indian J Thorac Cardiovasc Surg. 2022 Mar;38(2):142-148. doi: 10.1007/s12055-021-01299-7. Epub 2022 Jan 23.
OBJECTIVES
The diagnosis of interstitial lung disease is based on clinical and biological analysis associated with computed tomography (CT) pattern after discussion in multidisciplinary discussion. Lung transbronchial cryobiopsy has emerged with acceptable diagnostic reliability and low morbidity and mortality. The goal of our work is to describe our experience with lung cryobiopsy.
METHODS
This is monocentric and retrospective analysis of prospectively collected data on epidemiological, clinical, biological, CT, respiratory and histological features of patients with lung transbronchial cryobiopsy between January 1st, 2017, and July 1st, 2020.
RESULTS
Lung transbronchial cryobiopsy has been done for 23 patients with sex ratio M/F of 1.1, majority of smoker/former smoker. Thirty-nine percent of procedures were complicated by pneumothorax. On the haemorrhagic level, we reported 1 grade 2 bleeding (no serious bleeding). An histological diagnosis was obtained for 19 patients (82%). Only 4 patients needed to discuss surgical lung biopsy: 2 (8.6%) surgical lung biopsy, 1 refused surgical lung biopsy and 1 patient lost to follow-up.
CONCLUSION
Our results suggest that transbronchial lung cryobiopsy may be considered the first diagnostic modality instead of surgical lung biopsy for interstitial lung disease in appropriate patients. Larger studies are, however, needed to confirm our observations.
目的
间质性肺疾病的诊断基于多学科讨论后结合计算机断层扫描(CT)表现的临床和生物学分析。经支气管肺冷冻活检已出现,其诊断可靠性可接受,发病率和死亡率较低。我们这项工作的目的是描述我们在肺冷冻活检方面的经验。
方法
这是一项单中心回顾性分析,对2017年1月1日至2020年7月1日期间接受经支气管肺冷冻活检患者的流行病学、临床、生物学、CT、呼吸和组织学特征的前瞻性收集数据进行分析。
结果
对23例患者进行了经支气管肺冷冻活检,男女比例为1.1,大多数为吸烟者/既往吸烟者。39%的操作并发气胸。在出血方面,我们报告了1例2级出血(无严重出血)。19例患者(82%)获得了组织学诊断。仅4例患者需要讨论外科肺活检:2例(8.6%)进行了外科肺活检,1例拒绝外科肺活检,1例患者失访。
结论
我们的结果表明,对于合适的间质性肺疾病患者,经支气管肺冷冻活检可被视为替代外科肺活检的首选诊断方式。然而,需要更大规模的研究来证实我们的观察结果。