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接受支气管内超声引导下经支气管纵隔冷冻活检(冷冻EBUS)患者的临床和操作特征:哥伦比亚人群的描述性研究

Clinical and Procedural Characteristics of Patients Undergoing Endobronchial Ultrasound-Guided Transbronchial Mediastinal Cryobiopsy (CryoEBUS): A Descriptive Study in a Colombian Population.

作者信息

Echeverri-Hoyos Jacobo, Echeverri Franco Jaime A, Tuta-Quintero Eduardo

机构信息

School of Medicine, Institución Universitaria Visión de las Américas, Pereira, COL.

Pulmonology, Clínica de Alta Tecnología Oncólogos del Occidente, Pereira, COL.

出版信息

Cureus. 2025 Aug 2;17(8):e89253. doi: 10.7759/cureus.89253. eCollection 2025 Aug.

Abstract

Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (CryoEBUS) is an emerging minimally invasive technique that provides larger, better-preserved samples compared to conventional needle aspiration, improving suitability for histopathological and molecular testing. This retrospective study aimed to characterize the clinical profile, procedural aspects, and diagnostic yield of CryoEBUS in patients undergoing biopsy for mediastinal lesions. Fifty-nine patients underwent CryoEBUS. The mean age was 64.4 years (SD: 15.8), and 54% were men. Systemic arterial hypertension was the most common comorbidity (34%). The most frequent presenting symptoms were cough (66.1%) and chest pain (32.2%). CryoEBUS was performed for mediastinal lesion sampling, with an average of 1.5 lymph node stations biopsied per patient. Station selection was based on imaging characteristics (size ≥10 mm or fluorodeoxyglucose (FDG) uptake). Freeze time ranged from four to six seconds. Histopathology confirmed malignancy in 76% of cases, with adenocarcinoma being the most common subtype (42%). Diagnostic success, defined as the acquisition of a conclusive histopathological diagnosis, was achieved in 93% of cases. Minor complications occurred in 17%, primarily self-limited bleeding. CryoEBUS appears to be a safe and effective diagnostic tool for mediastinal lesion evaluation. Its ability to provide high-quality tissue samples supports its clinical utility, especially when molecular or immunohistochemical studies are required for diagnosis and treatment planning.

摘要

支气管内超声引导下经支气管纵隔冷冻活检(CryoEBUS)是一种新兴的微创技术,与传统针吸活检相比,它能获取更大、保存更好的样本,提高了组织病理学和分子检测的适用性。这项回顾性研究旨在描述接受纵隔病变活检患者的CryoEBUS临床特征、操作方面及诊断率。59例患者接受了CryoEBUS检查。平均年龄为64.4岁(标准差:15.8),54%为男性。系统性动脉高血压是最常见的合并症(34%)。最常见的症状是咳嗽(66.1%)和胸痛(32.2%)。进行CryoEBUS是为了对纵隔病变进行采样,每位患者平均活检1.5个淋巴结站。站点选择基于影像学特征(大小≥10毫米或氟脱氧葡萄糖(FDG)摄取情况)。冷冻时间为4至6秒。组织病理学证实76%的病例为恶性,腺癌是最常见的亚型(42%)。93%的病例获得了确定性组织病理学诊断,即诊断成功。17%发生了轻微并发症,主要是自限性出血。CryoEBUS似乎是评估纵隔病变的一种安全有效的诊断工具。它提供高质量组织样本的能力支持了其临床应用价值,特别是在诊断和治疗规划需要进行分子或免疫组化研究时。

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