Comparison of Cryobiopsy and Forceps Biopsy in Suspected Lung Carcinoma Patients with Endobronchial Lesions: A Cross-sectional Study

Abstract

Introduction: Forceps Biopsy (FB) is usually used to obtain tissue in endobronchial lesions through a flexible bronchoscope. The mean diagnostic rate of bronchoscopic FB is 74% in central tumours. A limitation of FB is the small tissue size and the occurrence of crush artifacts. In contrast, Cryobiopsy (CB) provides larger samples without such artifacts, which are crucial for accurate histopathological diagnoses. Aim: To compare the efficacy and safety of CB with FB in endobronchial mass lesions suspected of lung cancer. Materials and Methods: A cross-sectional study was conducted on suspected endobronchial mass lesions with suspicion of malignancy from October 2015 to March 2017. About 35 patients fulfilling the inclusion criteria were enrolled, and five of these 35 patients were excluded as they were diagnosed with benign lesions. Among these 30 patients, a flexible biopsy was obtained first followed by CB using the same endobronchial cryobiopsy. Data were analysed in terms of tissue viability, mean tissue size, diagnostic yield, complications, and histological diagnosis. Parameters were compared using the Chi-square test (χ2 test) and Fisher’s exact test. Results: The mean age of the study participants was 58.33±10.12 years. The mean±SD size (diameter) of tissue obtained by CB (0.73±0.47 cm) was higher than that of FB (0.23±0.08 cm) (p-value<0.001). The diagnostic yield obtained by CB was 96.7% compared to 70% in FB (p-value<0.005). Mild bleeding was seen in 86.7% of the CB group and in 60% of the FB group (p-value=0.019). None of the patients in the study experienced moderate or severe bleeding. Conclusion: CB emerges as a safe and dependable method, offering superior diagnostic outcomes compared to conventional FB with its capability to obtain larger biopsy samples and good-quality tissue while minimal bleeding. CB stands as a viable alternative to FB.

Keywords

• diagnostic yield
• endobronchial cryobiopsy
• safety