在快速现场评估指导下,低温活检作为胸膜负性柔性钳活检后的抢救技术:一项前瞻性研究。

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM
Canadian respiratory journal Pub Date : 2025-08-12 eCollection Date: 2025-01-01 DOI:10.1155/carj/6641774
Jianlong Tan, Cuihua Zhang, Bing Liu, Yun Li, Zhiguang Liu, Weidong Zhang
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引用次数: 0

摘要

弥漫性增厚或硬胸膜是一种与良性或恶性疾病相关的特殊类型的宏观外观。医学胸腔镜(MT)是胸膜病理的金标准,但其诊断率并不完善。虽然冷冻活检可以提供更大更深的组织,但其对诊断的影响仍然不确定,安全性问题仍然存在。在快速现场评估(ROSE)的指导下,我们评估了冷冻探针活检作为MT期间阴性或不确定的柔性钳活检后的抢救技术的有效性和安全性。这项前瞻性研究纳入了280例未确诊的渗出性胸腔积液患者,他们接受了MT。在最初的柔性钳活检和ROSE后,37例ROSE阴性的患者接受了冷冻探针活检。37例患者(男21例,女16例),年龄56.43±16.09(范围:22-78)岁,ROSE阴性,行冷冻活检。CB在33/37(89.2%)患者中建立了明确的组织病理学诊断,显著高于FFB,即21/37 (56.8%,p=0.002)。与FFB(2.89±1.15 mm)相比,CB导致胸膜标本明显增大(9.86±2.69 mm), 95%可信区间[CI]: 6.01-7.93; p < 0.001)。此外,CB比FFB更快(中位持续时间分别为15和31分钟;p < 0.001)。在20例NSCLC患者中,与FFB相比,CB改善了CGP检测的组织质量(18/20比8/15,p=0.036)。无明显并发症。冷冻探针活检是一种安全有效的抢救技术,适用于软性钳活检阴性的未确诊胸腔积液患者。它提供更大、更高质量的标本,阳性率更高,潜在地避免了重复手术的需要,有助于及时诊断和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Cryobiopsy as a Salvage Technique Following Negative Flexible Forceps Biopsy of the Pleura Under Rapid On-Site Evaluation Guidance: A Prospective Study.

Cryobiopsy as a Salvage Technique Following Negative Flexible Forceps Biopsy of the Pleura Under Rapid On-Site Evaluation Guidance: A Prospective Study.

Cryobiopsy as a Salvage Technique Following Negative Flexible Forceps Biopsy of the Pleura Under Rapid On-Site Evaluation Guidance: A Prospective Study.

Cryobiopsy as a Salvage Technique Following Negative Flexible Forceps Biopsy of the Pleura Under Rapid On-Site Evaluation Guidance: A Prospective Study.

A diffusely thickened or hard pleura is a special type of macroscopic appearance associated with benign or malignant conditions. Medical thoracoscopy (MT) is the gold standard for pleural pathology, but its diagnostic yield is imperfect. Although cryobiopsy may provide greater and deeper tissue, its impact on the diagnostic yield remains uncertain, and safety concerns persist. We evaluated the efficacy and safety of cryoprobe biopsy as a salvage technique following negative or inconclusive flexible forceps biopsy during MT under the guidance of rapid on-site evaluation (ROSE). This prospective study enrolled 280 patients with undiagnosed exudative pleural effusion who underwent MT. After the initial flexible forceps biopsy and ROSE, 37 patients with negative ROSE results underwent cryoprobe biopsy. A total of 37 (21 males and 16 females) patients, aged 56.43 ± 16.09 (range: 22-78) years with negative ROSE results, underwent cryoprobe biopsy. CB established a definitive histopathological diagnosis in 33/37 (89.2%) patients, which was significantly higher than that achieved with FFB, i.e., 21/37 (56.8%; p=0.002). CB resulted in significantly larger pleural specimens (9.86 ± 2.69 mm) in comparison to FFB (2.89 ± 1.15 mm, 95% confidence interval [CI]: 6.01-7.93; p < 0.001). Furthermore, CB was faster than FFB (median durations of 15 and 31 min, respectively; p < 0.001). CB had improved tissue quality for CGP testing in 20 NSCLC patients compared to FFB (18/20 versus 8/15, p=0.036). No significant complications were noted. Cryoprobe biopsy is a safe and effective salvage technique for patients with undiagnosed pleural effusion who show negative results on flexible forceps biopsy during MT. It provides larger, higher-quality specimens with a higher positivity rate, potentially avoiding the need for repeat procedures and facilitating timely diagnosis and treatment.

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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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