Yu Min, Xu Xuefeng, Xin Xiaoyan, Yang Shangwen, Wang Yihua, Xiao Yonglong, Shi Shenyun, Feng Xuebing
Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, 210008, Jiangsu, China.
Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, China.
Eur J Med Res. 2025 Mar 14;30(1):171. doi: 10.1186/s40001-025-02435-4.
Transbronchial lung cryobiopsy (TBLC) has been identified to be a new technique to diagnosis interstitial lung disease (ILD). The study was conducted to investigate the safety and the diagnostic accuracy of TBLC contrast with transbronchial lung biosy (TBLB) in patients with ILD.
In a cross-sectional and comparative study, patients with suspected ILD who underwent TBLC or TBLB were evaluated from June 2018 to September 2022 in Nanjing drum tower hospital. TBLC and TBLB procedure details and clinical multidisciplinary discussion (MDD) diagnosis based on clinical, radiological, and histopathological information were retrospectively analyzed. Diagnostic yield and complications of TBLC and TBLB were evaluated.
187 patients who underwent TBLC and 176 patients who underwent TBLB following a standardized protocol were enrolled. The diagnostic yield of TBLC and TBLB in patients with ILD were 85.0% and 63.1%, respectively. In TBLC, 162 patients (86.6%) had no or mild bleeding and 25 patients (13.4%) had moderate bleeding. None of the patients had severe bleeding and the rate of pneumothorax was 14.4%. Comparatively, pooled incidences of complications were 91.5% for no or mild bleeding, 8.5% for moderate bleeding and 5.1% for pneumothorax after TBLB. There was no difference in the occurrence of bleeding among TBLC group and TBLB group.
This study indicated that the clinical applicability of TBLC in ILD diagnostic algorithms, with a diagnostic yield of 85.0% and an acceptable safety profile.
经支气管肺冷冻活检（TBLC）已被确定为诊断间质性肺疾病（ILD）的一项新技术。本研究旨在探讨TBLC与经支气管肺活检（TBLB）相比，在ILD患者中的安全性及诊断准确性。
在一项横断面比较研究中，对2018年6月至2022年9月在南京鼓楼医院接受TBLC或TBLB的疑似ILD患者进行评估。回顾性分析TBLC和TBLB的操作细节以及基于临床、影像学和组织病理学信息的临床多学科讨论（MDD）诊断结果。评估TBLC和TBLB的诊断率及并发症。
187例按标准化方案接受TBLC的患者和176例接受TBLB的患者纳入研究。ILD患者中TBLC和TBLB的诊断率分别为85.0%和63.1%。在TBLC中，162例患者（86.6%）无出血或轻度出血，25例患者（13.4%）中度出血。无患者发生严重出血，气胸发生率为14.4%。相比之下，TBLB后无出血或轻度出血的合并发生率为91.5%，中度出血为8.5%，气胸为5.1%。TBLC组和TBLB组出血发生率无差异。
本研究表明，TBLC在ILD诊断算法中具有临床适用性，诊断率为85.0%，安全性可接受。
