{"title":"Efficacy of cryobiopsy during medical thoracoscopy for diagnosing malignant pleural mesothelioma","authors":"Hayato Nanami , Yuji Matsumoto , Hideaki Furuse , Midori Tanaka , Takaaki Tsuchida , Yuichiro Ohe","doi":"10.1016/j.lungcan.2024.108074","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Malignant pleural mesothelioma (MPM) is difficult to differentiate from other pleural diseases, and its diagnosis requires adequate tissue sampling. Although medical thoracoscopy is an established diagnostic procedure for pleural diseases, there is no consensus on whether it guarantees a high diagnostic yield for MPM. Cryobiopsy has been shown to have the potential to improve tissue sampling in other diseases; therefore, we aimed to investigate its efficacy in diagnosing MPM.</div></div><div><h3>Material and Methods</h3><div>Patients who underwent medical thoracoscopy at our institution between January 2013 and June 2023 and were finally diagnosed with MPM were analyzed. Patients who underwent biopsies with forceps and/or electrocautery devices were defined as the conventional group, whereas those who underwent biopsies with an additional cryoprobe were categorized as the cryo group. Diagnostic performance was compared between the two groups.</div></div><div><h3>Results</h3><div>Among 347 patients who underwent medical thoracoscopy, 69 patients, 34 in the cryo group and 35 in the conventional group, were diagnosed with MPM. The overall diagnostic yield was 76.8 %, and the cryo group had a significantly higher yield than the conventional group (88.2 % vs. 65.7 %, <em>P</em> = 0.044). Furthermore, the subtype was confirmed in most of the patients in the cryo group but only in approximately two-thirds of those in the conventional group (79.4 % vs. 42.9 %, <em>P</em> = 0.003). Regarding safety, two patients (5.9 %) developed pneumothorax in the cryo group, and two (5.7 %) developed pneumonia in the conventional group.</div></div><div><h3>Conclusion</h3><div>Cryobiopsy is effective in improving the subtype confirmation rate as well as MPM diagnostic yield compared to conventional biopsy.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"199 ","pages":"Article 108074"},"PeriodicalIF":4.5000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lung Cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0169500224006081","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
Malignant pleural mesothelioma (MPM) is difficult to differentiate from other pleural diseases, and its diagnosis requires adequate tissue sampling. Although medical thoracoscopy is an established diagnostic procedure for pleural diseases, there is no consensus on whether it guarantees a high diagnostic yield for MPM. Cryobiopsy has been shown to have the potential to improve tissue sampling in other diseases; therefore, we aimed to investigate its efficacy in diagnosing MPM.
Material and Methods
Patients who underwent medical thoracoscopy at our institution between January 2013 and June 2023 and were finally diagnosed with MPM were analyzed. Patients who underwent biopsies with forceps and/or electrocautery devices were defined as the conventional group, whereas those who underwent biopsies with an additional cryoprobe were categorized as the cryo group. Diagnostic performance was compared between the two groups.
Results
Among 347 patients who underwent medical thoracoscopy, 69 patients, 34 in the cryo group and 35 in the conventional group, were diagnosed with MPM. The overall diagnostic yield was 76.8 %, and the cryo group had a significantly higher yield than the conventional group (88.2 % vs. 65.7 %, P = 0.044). Furthermore, the subtype was confirmed in most of the patients in the cryo group but only in approximately two-thirds of those in the conventional group (79.4 % vs. 42.9 %, P = 0.003). Regarding safety, two patients (5.9 %) developed pneumothorax in the cryo group, and two (5.7 %) developed pneumonia in the conventional group.
Conclusion
Cryobiopsy is effective in improving the subtype confirmation rate as well as MPM diagnostic yield compared to conventional biopsy.
期刊介绍:
Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.