使用 1.1 毫米冷冻探针进行经支气管肺冷冻活组织检查诊断间质性肺病的效率和安全性

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM
Lung Pub Date : 2024-10-01 Epub Date: 2024-06-23 DOI:10.1007/s00408-024-00713-2
Yiding Bian, Mingming Deng, Qian Gao, Guowu Zhou, Run Tong, Ling Zhao, Min Liu, Jie Sun, Huaping Dai, Felix J F Herth, Gang Hou, Chen Wang
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引用次数: 0

摘要

简介经支气管肺冷冻活组织检查(TBLC)越来越多地用于诊断间质性肺病(ILD)。最近,1.1 毫米冷冻探针已可用于临床实践。使用 1.1 毫米冷冻探针进行 TBLC 的诊断率和安全性有待证实:方法:对疑似 ILD 患者进行了一项前瞻性随机对照试验,随机分配到 1.1 毫米和 1.9 毫米低温探针组。主要结果是多学科讨论的诊断率。次要结果是样本质量和并发症发生率。此外,还使用有限元分析评估了 1.1 毫米和 1.9 毫米冷冻探针在 TBLC 期间对靶叶造成的张力和应力效应:共有 224 名患者入选。1.9 毫米冷冻探针组与 1.1 毫米冷冻探针组的诊断率(80.4% vs. 79.5%,p = 0.845)和样本质量评分(5.73 ± 0.64 vs. 5.66 ± 0.77;p = 0.324)无明显差异。1.1 毫米冷冻探针组样本的平均表面积较小,而样本重量则无差异。1.1 毫米冷冻探针组的中度出血发生率降低(17.0% 对 6.2%,P = 0.027),气胸发生率没有差异,但 1.1 毫米组的气胸发生率有升高的趋势。在有限元分析中,1.1 毫米冷冻探针需要的张力最大,产生的应力也最大:结论:与 1.9 毫米冷冻探针相比,1.1 毫米冷冻探针的标本质量和诊断率没有差异,但样本量较小。1.1毫米低温探针的中度出血风险降低,但气胸风险有增加的趋势:Clinicaltrials.gov标识符NCT04047667;2019年8月4日注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Diagnostic Efficiency and Safety of Transbronchial Lung Cryobiopsy Using 1.1-mm Cryoprobe in Diagnosing Interstitial Lung Disease.

The Diagnostic Efficiency and Safety of Transbronchial Lung Cryobiopsy Using 1.1-mm Cryoprobe in Diagnosing Interstitial Lung Disease.

Introduction: Transbronchial lung cryobiopsy (TBLC) is increasingly used to diagnose interstitial lung disease (ILD). The 1.1-mm cryoprobe has recently been available in clinical practice. The diagnostic yield and safety of TBLC using a 1.1-mm cryoprobe need to be confirmed.

Methods: A prospective, randomized controlled trial was conducted in patients with suspected ILD and randomly assigned to 1.1-mm and 1.9-mm cryoprobe groups. The primary outcome was the diagnostic yield of multidisciplinary discussion. Secondary outcomes were sample quality and incidence of complications. The tension and stress effects during TBLC onto the target lobe caused by 1.1-mm and 1.9-mm cryoprobes were also evaluated using finite element analysis.

Results: A total of 224 patients were enrolled. No significant differences were observed in the diagnostic yield (80.4% vs. 79.5%, p = 0.845) and sample quality scores (5.73 ± 0.64 vs. 5.66 ± 0.77; p = 0.324) between the 1.9-mm cryoprobe group and 1.1-mm cryoprobe group. The average surface areas of samples in 1.1-mm cryoprobe group were smaller, while no difference in sample weights was observed. A decreased incidence of moderate bleeding was found in the 1.1-mm cryoprobe group (17.0% vs. 6.2%, p = 0.027), while there was no difference in the incidence of the pneumothorax, there was a trend to higher rate of pneumothorax in 1.1-mm group. In finite element analysis, the 1.1-mm cryoprobe required the largest tension and produced the largest stress.

Conclusion: Compared with a 1.9-mm cryoprobe, there was no difference in specimen quality or diagnostic rate but smaller sample size with a 1.1-mm cryoprobe. There was a decreased risk of moderate bleeding, but a trend towards increased risk for pneumothorax with 1.1-mm cryoprobe.

Trail registration: Clinicaltrials.gov identifier NCT04047667; registered August 4, 2019.

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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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