Diagnostic yield and safety of bronchoscopic lung cryobiopsy in evaluation of pulmonary lesions
M. Encheva*a (Prof), S. Zabadanovaa (Dr), E. Nasevab (Prof), G. Hinkova (Dr), H. Yordanova (Dr), P. Titorenkova (Dr)
a Military Medical Academy, Sofia, BULGARIA ; b Medical University of Sofia, Sofia, BULGARIA
Background: Endobronchial and peripheral pulmonary lesions are commonly considered as neoplasms until proven otherwise. Bronchoscopic lung cryobiopsy (BLCB) is a novel technique for diagnosing histologically transbronchial and endobronchial large samples obtained with minimal artifacts.
Objectives: Diagnostic yield of BLCB in central and peripheral pulmonary lesions; relationship between demographic data and risk factors of the patients and the histological variant of the identified neoplasm.
Methods: A retrospective study (January 2021 - January 2022) of 131 patients with CT-positives pulmonary lesions (central and peripheral) who underwent BLCB using 2.4 and 1.9 mm cryoprobe. Diagnostic yield of BLCB was analysed as a positive diagnosis after histological and immunohistochemical examination along with the compilations rate of the procedure.
Results: Neoplasms were identified in 94.6% of 373 biopsies, performed on 131 patients. 95.7% of patients with centrally located lesions (n=116) showed neoplasms. The total number of biopsies in patients with peripheral lesions (n=15) was 33 as 22 of them showed neoplasm (66.7%). A relationship between lesions location and histological outcome was established (p<0.001). In patients with adenocarcinoma, the number of comorbidities was significantly lower (p=0.009). Squamous cell carcinoma was more common in patients with comorbidities (p<0.0001) - COPD (p=0.024), AH (p=0.05), DM (p=0.008). The age of patients with squamous cell carcinoma was significantly higher (p=0.005), and the number of comorbidities was substantially greater (p=0.001). The mean age of carcinoid patients was significantly lower (p=0.003). Carcinoid was considerably more common in non-smokers (p=0.012) with no risk factors (p=0.010). Metastasis were found much more frequently among patients with any neoplasm (p<0.001). Bleeding after BLCB occurred in 29% of cases; no pneumothorax was found. Bleeding was observed more commonly after BLCB of metastases (p=0.059)
Conclusions: BLCB represents a safer and promising technique with a great diagnostic yield in identification of central and peripheral pulmonary lesions.
Disclosure of funding source(s): none