Chen Boyi, Leng Zhefeng, Zhang Jianhui, Shi Xuefei, Dong Shunli, Wang Bin
Department of Respiratory Medicine, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, People's Republic of China.
Department of Respiratory Medicine, Fifth School of Clinical Medicine of Zhejiang, Huzhou Central Hospital, Chinese Medical University, Huzhou, People's Republic of China.
Lung. 2025 Jan 3;203(1):16. doi: 10.1007/s00408-024-00758-3.
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic lung disorder characterized by dry cough, fatigue, and exacerbated dyspnea. The prognosis of IPF is notably unfavorable, becoming extremely poor when the disease advances acutely. Effective therapeutic intervention is essential to mitigate disease progression; hence, early diagnosis and treatment are paramount. When high-resolution computed tomography (HRCT) reveals usual interstitial pneumonia (UIP), a diagnosis of IPF can be established. However, when HRCT fails to conclusively confirm IPF, the diagnostic pathway becomes intricate and necessitates a multidisciplinary approach involving clinicians, radiologists, and pathologists. Consequently, the objective of this study was to investigate new diagnostic approaches through bronchoalveolar lavage (BAL) analysis.
BAL is a commonly utilized diagnostic tool for interstitial lung diseases. We review the application of bronchoalveolar lavage (BALF) in idiopathic pulmonary fibrotic disease, emphasizing that the cellular and solute composition of the lower respiratory tract offers valuable insights.
This review delineates the advancements in diagnosing IPF cases that remain indeterminate via HRCT, leveraging BALF analysis. In contrast to surgical lung biopsy, BAL is minimally invasive and offers potential diagnostic utility through the identification of specific BALF biomarkers.
Augment the clinical diagnostic armamentarium for IPF, particularly in scenarios where HRCT findings are inconclusive.
特发性肺纤维化（IPF）是一种慢性进行性纤维化肺部疾病，其特征为干咳、疲劳和进行性加重的呼吸困难。IPF的预后明显不佳，疾病急性进展时预后极差。有效的治疗干预对于减缓疾病进展至关重要；因此，早期诊断和治疗至关重要。当高分辨率计算机断层扫描（HRCT）显示普通型间质性肺炎（UIP）时，可确立IPF的诊断。然而，当HRCT未能明确确诊IPF时，诊断途径变得复杂，需要临床医生、放射科医生和病理科医生采取多学科方法。因此，本研究的目的是通过支气管肺泡灌洗（BAL）分析来研究新的诊断方法。
BAL是间质性肺疾病常用的诊断工具。我们回顾了支气管肺泡灌洗（BALF）在特发性肺纤维化疾病中的应用，强调下呼吸道的细胞和溶质组成提供了有价值的见解。
本综述阐述了利用BALF分析诊断经HRCT仍无法确诊的IPF病例的进展。与外科肺活检相比，BAL具有微创性，并通过识别特定的BALF生物标志物提供潜在的诊断效用。
增强IPF的临床诊断手段，尤其是在HRCT结果不明确的情况下。
