Di-san junyi daxue xuebao (Sep 2019)

Efficacy and safety of transbronchial cryobiopsy in diagnosis of interstitial pneumonia with autoimmune features

  • JIANG Tao,
  • GUO Shuliang,
  • Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China,
  • JIANG Jinyue,
  • AO Zhi

DOI
https://doi.org/10.16016/j.1000-5404.201904095
Journal volume & issue
Vol. 41, no. 17
pp. 1682 – 1687

Abstract

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Objective To evaluate the effectiveness and safety of transbronchial cryobiopsy (TBCB) in the diagnosis of interstitial pneumonia with autoimmune features (IPAF). Methods From December 2015 to December 2018, TBCB was performed in the patients with interstitial lung disease of uncertain origin. The cases within the IPAF diagnostic criteria were selected, and their clinical, radiological and pathological data were collected and analyzed to evaluate the diagnostic effect of TBCB for IPAF. The complications of TBCB were recorded. Results Among the 83 cases undergoing TBCB, 15 eligible IPAF cases were screened out by a mode of clinical-radiological-pathological diagnosis (CRP), while only 8 cases were diagnosed as IPAF with clinical-radiological diagnosis (CR). It took averagely 31.7±14.2 min for TBCB procedure, and the medium area of the obtained specimens was 10 (7, 15) mm2. One patient developed mild pneumothorax after the procedure, which was absorbed after oxygen inhalation. Hemorrhage of different volumes occurred during the procedure (1 case of severe hemorrhage) in 15 patients, which was controlled with hemostatic measures. The common initial symptoms were cough and dyspnea. The most common manifestations in immune system were technician hand, Raynaud phenomenon, and dry mouth and dry eye and so on. Serological tests were positive to antinuclear antibodies in 12 cases (80%) and to anti-R0-52 antibodies in 10 cases (66.7%). The main pulmonary function deficiencies were decrease in diffuse function, and the average 6-minute-walking distance was 388.5±88.4 m. The main features on chest high resolution computed tomography (HRCT) and pathological examination were as those of non-specific interstitial pneumonia (NSIP). Conclusion TBCB improves the diagnostic rate of IPAF with a satisfactory safety.

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