Abstract

Reports on the use of cryobiopsy (CB) for lung cancer diagnosis are limited. The aims of the present study were to evaluate the safety and usefulness of CB using radial endobronchial ultrasonography, without a guide sheath, for the diagnosis of peripheral pulmonary lesions and determine the utility of stamp cytology, an on-site diagnostic technique for determining tumor inclusion in CB samples. We retrospectively analyzed data for 35 patients (36 lesions) with suspected peripheral lung cancer who underwent CB between August 2017 and February 2019 at our medical facility. The diagnostic yield, incidence of complications, and the utility of stamp cytology for diagnosis were investigated. The diagnostic yield of CB was 86.1% (31/36) with histological diagnosis, and 80.5% (29/36) with diagnosis using stamp cytology; the overall yield was 91.6% (33/36). Pneumothorax requiring thoracic drainage occurred in two patients, both of whom had lesions contacting the pleura. Grade 2 and grade 1 bleeding occurred in one and 25 patients, respectively. CB enables the collection of very large, nearly intact tissue samples, thus resulting in an improvement in the true diagnosis rate and facilitating the measurement of multiple biomarkers as well as rapid histological diagnosis.

Highlights

  • Lung cancer is associated with a very high mortality rate, with non-small cell lung cancer (NSCLC) accounting for 85% of cases [1]

  • For end-stage NSCLC, along with the promotion of techniques based on individualized medicine, the list of immunohistochemical and molecular tests necessary for determining treatment plans and objectives is increasing on a daily basis

  • forceps biopsy (FB) was not performed for all patients, the biopsy number was not specified beforehand, and the analysis was retrospective and limited to a single center; it was difficult to compare the results for CB with those for FB in order to evaluate the diagnostic power

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Summary

Introduction

Lung cancer is associated with a very high mortality rate, with non-small cell lung cancer (NSCLC) accounting for 85% of cases [1]. For end-stage NSCLC, along with the promotion of techniques based on individualized medicine, the list of immunohistochemical and molecular tests necessary for determining treatment plans and objectives is increasing on a daily basis. The conventional technique of forceps biopsy (FB) does not allow the collection of sufficient, good-quality cells, a problem that continues to become more common. The attachment of a flexible cryoprobe to bronchoscopes was first reported in a study that examined its usefulness for eliminating tracheobronchial obstruction [5].

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