Transbronchial lung cryobiopsy for connective tissue disease-related interstitial lung disease and interstitial pneumonia with autoimmune features: a single center retrospective case series
Transbronchial lung cryobiopsy for connective tissue disease-related interstitial lung disease and interstitial pneumonia with autoimmune features: a single center retrospective case series
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经支气管肺冷冻活检治疗结缔组织病相关间质性肺病和具有自身免疫特征的间质性肺炎：单中心回顾性病例系列
DOI：
10.1007/s10067-021-05671-1
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发表时间：
2021-03-03
影响因子：
3.4
通讯作者：
Liu, Hong
中科院分区：
文献类型：
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作者：
Wu, Wen-jue;Mo, Han-You;Liu, Hong
经支气管肺冷冻活检（TBLC）最近被引入用于诊断间质性肺疾病。我们的目的是通过确定结缔组织病相关间质性肺病（CTD-ILD）和具有自身免疫特征的间质性肺炎（IPAF）诊断的组织学模式来评估TBLC的有效性和安全性。方法桂林医科大学附属医院2017年7月1日至2020年10月31日期间的临床-放射学-病理学数据，回顾性分析和总结临床-放射学或临床-放射学-病理诊断为CTD-ILD或IPAF并接受TBLC、经支气管肺活检（TBLB）或手术肺活检的患者的例数。活检样本的大小，并发症和诊断率进行了compared.Results14例符合纳入标准，其中12例接受TBLC，1例接受TBLB，1例在不同的时间进行每个程序。与TBLB标本的尺寸（5.625 ± 0.479 mm 2）相比，TBLC标本的尺寸（12.00（12.00，15.00）mm 2）更大（Z=-3.262，P = 0.001）。TBLC和TBLB的诊断率分别为100.00%（13/13）和0.00%（2/2）（P= 0.0095）。最常见的并发症是轻度出血。TBLB之间的出血风险（1/2，50.00%）和TBLC（10/13，76.92%）差异无显著性结论TBLC可有效鉴别可疑CTD-ILD或IPAF患者的组织学类型，增加额外的诊断价值，关键点·经支气管肺冷冻活检最近被引入用于诊断间质性肺病。·经支气管肺冷冻活检被认为是有效和安全的诊断怀疑间质性肺疾病的患者。当临床-放射学诊断不确定时，可作为活检的首选方法。
ObjectiveTransbronchial lung cryobiopsy (TBLC) has been recently introduced for diagnosing interstitial lung diseases. We aimed to assess the effectiveness and safety of TBLC by identifying the specific patterns of histology in the diagnosis of connective tissue disease–related interstitial lung disease (CTD-ILD) and interstitial pneumonia with autoimmune features (IPAF).MethodsThe clinical-radiological-pathological data from the Affiliated Hospital of Guilin Medical University between July 1, 2017, and October 31, 2020, of patients whose clinical-radiological or clinical-radiological-pathological diagnosis was CTD-ILD or IPAF and who underwent TBLC, transbronchial lung biopsy (TBLB), or surgical lung biopsy were retrospectively analyzed and summarized with review. The size of biopsy samples, complications, and diagnostic yield were compared.ResultsFourteen patients met the inclusion criteria, of whom 12 underwent TBLC, 1 underwent TBLB, and 1 underwent each procedure at different times. Compared to the size of TBLB specimens (5.625 ± 0.479 mm2), the size of TBLC specimens (12.00 (12.00, 15.00) mm2) was much larger (Z= − 3.262,P= 0.001). The diagnostic yields of TBLC and TBLB were 100.00% (13/13) and 0.00% (2/2), respectively (P= 0.0095). The most frequent complication was mild bleeding. The risk of bleeding between TBLB (1/2, 50.00%) and TBLC (10/13, 76.92%) did not differ significantly (P= 0.469).ConclusionTBLC can add extra diagnostic value by effectively identifying specific types of histology for patients with suspected CTD-ILD or IPAF, with a procedure that is safe from adverse events.Key Points•Transbronchial lung cryobiopsy has been introduced recently for diagnosing interstitial lung disease.•Transbronchial lung cryobiopsy was found to be effective and safe in the diagnosis for patients with suspected interstitial lung disease. It can be used as a preferred method for biopsy when the clinical-radiological diagnosis is uncertain.