C. Zuoa (Dr), M. Ke*a (Prof)

a The Second Affiliated Hospital of Xiamen Medical College, Xiamen, CHINA

* lyf781030@sina.com

Background Transbronchial Frozen Lung Biopsy (TBCB) has become a minimally invasive alternative to surgical lung biopsy (SLB) due to its low cost and low trauma, but it still has a high rate of pathologic negative diagnosis and complications. Confocal laser microendoscopy (CLE) is a high-resolution optical imaging technique. Compared with traditional fluoroscopy, it has no radiation and is expected to be a tool to assist TBCB precise and effective operation.

Objectives By comparing the efficacy and safety of TBCB combined with CLE group and fluoroscopy group in the diagnosis of ILD, the application value of CLE assisted TBCB in ILD diagnosis was discussed.

Methods In this prospective controlled study, 60 ILD patients with unknown diagnosis who were hospitalized in the Second Affiliated Hospital of Xiamen Medical College from December 2020 to April 2022 and who needed lung biopsy were included. Based on the basic information of TBCB, the patients received CLE or fluoroscopy randomly. The positive pathological diagnosis rate, specimen size, operation time, complications and the coincidence rate of images and pathological diagnosis were compared between the two groups.

Results The positive rate of pathological diagnosis was found 92% in CLE group and 78% in fluoroscopy group ( p < 0.005), Biopsy specimen size (11.6±5.8)and (11.6±5.8)mm2( p > 0.005), Operation time(36.2±12.8)and(51.6±14.2)minutes( p < 0.005), The incidence of pneumothorax zero ratio(0/30)and 6.7%(2/30)( p < 0.005), Incidence of major bleeding 3.3%and 10.0%(p <0.005),respectively .The coincidence rate of CLE group images and pathological diagnosis was 93.3%.

Conclusions CLE images have a strong correlation with ILD etiology spectrum, can not only guide TBCB precise biopsy, improve the positive pathological diagnosis rate, but also reduce major bleeding and pneumothorax, shorten the operation time and avoid radiation, which has high clinical application value.

Keywords CLE; ILD; TBCB; value

Disclosure of funding source(s):

The project is a university-level science and technology project of Xiamen Medical College, project number: K2020-02, funded by Xiamen Medical College