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 paren-chymal lung disease group are numerous, differential di-agnosis between them is difficult and requires morpho-logical 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 vol-ume 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 pro-posed 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 ap-proaching 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 effi-cacy of transbronchial cryobiopsy versus transbronchial forceps biopsy in patients with diffuse parenchymal lung disease. Materials and methods. Inclusion criteria: pres-ence of diffuse parenchymal lung disease of unknown etiology, need for invasive diagnostics. Exclusion criteria: FEV1 less than 40%. Transbronchial forceps lung biop-sy and transbronchial lung cryobiopsy were performed simultaneously. Results. Of 21 patients included in the study, the process was verified in 17 (80.95%). Lung sar-coidosis 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. Transbron-chial cryobiopsy of the lung shows better efficacy in com-parison 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.