Comparison of transbronchial and open biopsies in chronic infiltrative lung diseases.
Comparison of transbronchial and open biopsies in chronic infiltrative lung diseases.
复制标题
慢性浸润性肺疾病经支气管活检和开放活检的比较。
DOI：
10.1164/arrd.1981.123.3.280
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
Hayes,JA
中科院分区：
文献类型：
--
作者：
Wall,CP;Gaensler,EA;Carrington,CB;Hayes,JA
为了确定经支气管活检（TBB）的诊断可靠性，我们进行了与开放式肺活检的前瞻性比较。所有未确诊的弥漫性浸润性（间质性）肺病患者均有TBB。当这是肿瘤、结节病或感染的特征时，不需要额外的活检。所有其他患者均行开放性活检。1976年1月至1980年5月期间，176例间质性疾病患者中，60例（34.1%）需要肺活检。经支气管活检禁忌7例，研究组53例。在这53例患者中，20例（37.7%）被诊断为TBB，其余33例缺乏明确组织诊断的患者的组织学表现为正常肺，10例；非特异性异常11例；间质性肺炎，6分；间质纤维化，3分；2 .标本不足；在这33例患者中，有92%的患者进行了开放性活检，这些诊断与最初的TBB诊断关系不大。我们的结论是，TBB诊断间质性肺炎、慢性炎症、非特异性反应和纤维化是不可靠的，往往完全误导。在本组中，需要开放性活检以达到特定的组织学诊断。
To ascertain the diagnostic reliability of transbronchial biopsy (TBB) a prospective comparison with open lung biopsy was made. All patients with undiagnosed diffuse infiltrative (interstitial) lung disease had a TBB. When this was characteristic of tumor, sarcoidosis, or infection, no additional biopsy was deemed necessary. In all other patients, an open biopsy was performed.Between January 1976 and May 1980, among 176 patients with interstitial disease, 60 (34.1%) required lung biopsy. Transbronchial biopsy was contraindicated in 7, leaving 53 in the study group. Among these 53 patients TBB was diagnostic in 20 (37.7%), and the histologic findings in the remaining 33 patients who lacked definitive tissue diagnoses were reported as normal lung, 10 patients; nonspecific abnormalities, 11 patients; interstitial pneumonia, 6; interstitial fibrosis, 3; inadequate specimen, 3. Open biopsy in these 33 patients resulted in specific diagnoses in 92%, and these diagnoses bore little relationship to the original TBB diagnoses. We concluded that TBB diagnoses of interstitial pneumonia, chronic inflammation, nonspecific reaction, and fibrosis are unreliable and often entirely misleading. In this group, an open biopsy is required to reach a specific histologic diagnosis.