Comparison of the efficacy of transbronchial cryobiopsy with transbronchial forceps biopsy in the diagnosis of diffuse parenchymal lung diseases

Abstract

Introduction. Pathologies included in the diffuse parenchymal lung disease group are numerous, differential diagnosis between them is difficult and requires morphological verification. There are minimally invasive methods of morphological verification, such as transbronchial forceps lung biopsy, which is less traumatic compared to surgical biopsy, but is accompanied by a smaller volume of biological material, which often contains artifacts due to damaging with forceps. In 2008, for the first time, a method of transbronchial lung cryobiopsy was proposed for morphological verification of lung diseases.
The effectiveness of cryobiopsy for diagnosing diffuse parenchymal lung diseases differs according to different
sources, however, based on the data of meta-analyses, it can be said that the effectiveness of cryobiopsy is approaching the “gold standard” of surgical lung biopsy. In Russia, however, the use of cryotechniques is limited to single clinical centers, which may be due to the lack of a sufficient number of publications in the domestic lit- erature. The aim of the study was to evaluate the efficacy of transbronchial cryobiopsy versus transbronchial forceps biopsy in patients with diffuse parenchymal lung disease. Materials and methods. Inclusion criteria: presence of diffuse parenchymal lung disease of unknown etiology, need for invasive diagnostics. Exclusion criteria: FEV1 less than 40%. Transbronchial forceps lung biopsy and transbronchial lung cryobiopsy were performed simultaneously. Results. Of 21 patients included in the study, the process was verified in 17 (80.95%). Lung sarcoidosis was detected in 12 (57.14%) cases, pulmonary tuberculosis — in 3 (14.28%), pulmonary mycobacterio- sis — in 2 (9.52%). The diagnosis was verified according to cryobiopsy in 15 patients (71.42%), according to for- ceps lung biopsy in 10 (47.61%). Conclusion. Transbronchial cryobiopsy of the lung shows better efficacy in comparison with transbronchial forceps biopsy. Cryobiopsy can be combined with transbronchial forceps biopsy if there is a pathology in the apex of the lungs and/or if it is impossible to place the cryoprobe in the “safe” zone.
Further research is needed to confirm the findings on a larger clinical material.