Endobronchial cryobiopsy or forceps biopsy for lung cancer diagnosis

Zafer Aktas, Ersin Gunay, Nevin Taci Hoca, Aydin Yilmaz, Funda Demirag, Sibel Gunay, Tugrul Sipit, Emine Bahar Kurt, Zafer Aktas, Ersin Gunay, Nevin Taci Hoca, Aydin Yilmaz, Funda Demirag, Sibel Gunay, Tugrul Sipit, Emine Bahar Kurt

Abstract

Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial brushing are widely used in diagnosis of lung cancers. The mean diagnostic rate with bronchoscopic forceps biopsy is 74% in central tumors. This study was designed to evaluate the efficacy of cryobiopsies in histopathological diagnosis.

Methods: Forty-one patients who had interventional bronchoscopy were included in this study. Three forceps biopsies and one cryobiopsy with cryorecanalization probe were obtained from each subject. Biopsies interpretations were done by one expert pathologist.

Results: Hemorrhage was the only complication in both procedures. There was no significant difference between these two procedures in the incidence of hemorrhage (P > 0.05). Mean diameters of samples taken with forceps biopsy and cryoprobe biopsy were 0.2 and 0.8 cm, respectively (P < 0.001). Thirty-two patients (78%) were diagnosed with forceps biopsies, and 38 patients (92.7%) were diagnosed with cryoprobe biopsies (P = 0.031).

Conclusions: We concluded that cryoprobe biopsies were more successful than forceps biopsies in diagnosis. Nevertheless, further investigations are warranted to determine an efficacy of cryoprobe biopsy procedures and a rationale to use as a part of routine flexible bronchoscopy.

Keywords: Biopsy; cryobiopsy; cryotherapy; interventional bronchoscopy; lung cancer.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Silvestri GA, Jett J. Bronchogenic carcinoma. In: Murray JF, Nadel JA, editors. Textbook of Respiratory Medicine. 4th ed. Vol. 3. Philadelphia: Elsevier Saunders; 2005. pp. 1357–82.
    1. Bilello KS, Murin S, Matthay RA. Epidemiology, etiology, and prevention of lung cancer. Clin Chest Med. 2002;23:1–25.
    1. Spiro SG, Porter JC. Lung cancer-Where are we today? Current advances in staging and nonsurgical treatment. Am J Respir Crit Care Med. 2002;166:1166–96.
    1. Rivera MP, Detterbeck F, Mehta AC. Diagnosis of lung cancer: The guidelines. Chest. 2003;123:129–36.
    1. Kvale PA. Collection and preparation of bronchoscopic specimens. Chest. 1978;73:707S–12.
    1. Vergnon JM, Huber RM, Moghissi K. Place of cryotherapy, brachytherapy and photodynamic therapy in therapeutic bronchoscopy of lung cancers. Eur Respir J. 2006;28:200–18.
    1. Hetzel M, Hetzel J, Schumann C, Marx N, Babiak A. Cryorecanalization: a new approach for the immediate management of acute airway obstruction. J Thorac Cardiovasc Surg. 2004;127:1427–31.
    1. Schumann C, Hetzel M, Babiak AJ, Hetzel J, Merk T, Wibmer T, et al. Endobronchial tumor debulking with a flexible cryoprobe for immediate treatment of malignant stenosis. J Thorac Cardiovasc Surg. 2010;139:997–1000.
    1. Hetzel J, Hetzel M, Hasel C, Moeller P, Babiak A. Old meets modern: The use of traditional cryoprobes in the age of molecular biology. Respiration. 2008;76:193–7.
    1. Babiak A, Hetzel J, Krishna G, Fritz P, Moeller P, Balli T, et al. Transbronchial cryobiopsy: A new tool for lung biopsies. Respiration. 2009;78:203–8.
    1. Travis WD, Brambilla E, Müller-Hermelink HK, Harris CC, editors. World Health Organisation Classification of Tumors. Pathology and Genetics of Tumors of the Lung, Pleura, Thymus and Heart. 4th ed. Geneva: WHO; 2004. p. 1.
    1. Pardin DM. Global cancer statistics in the year 2000. Lancet Oncol. 2001;2:533–43.
    1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–49.
    1. Cordasco EM, Mehta AC, Ahmad M. Bronchoscopically induced bleeding A summary of nine years’ cleveland clinic experience and review of the literature. Chest. 1991;100:1141–7.
    1. Credle WF, Jr, Smiddy JF, Elliott RC. Complications of fiberoptic bronchoscopy. Am Rev Respir Dis. 1974;109:67–72.
    1. Mak VH, Johnston ID, Hetzel MR, Grubb C. Value of washings and brushings at fiberoptic bronchoscopy in the diagnosis of lung cancer. Thorax. 1990;45:373–6.
    1. Popp W, Helmuth R, Ritschka L, Redtenbacher S, Zwick H, Dutz W. Diagnostic sensitivity of different techniques in the diagnosis of lung tumors with the flexible fiberoptic bronchoscope. Cancer. 1991;67:72–5.
    1. Tamboli P, Ro JY. Pathologic evaluation of lung cancer. In: Fossella FV, Komaki R, Putnam JB, editors. Lung Cancer. New York: Springer; 2003. pp. 57–80.
    1. Ohno N, Terada N, Bai Y, Saitoh S, Nakazawa T, Nakamura N, et al. Application of cryobiopsy to morphological and immunohistochemical analyses of xenografted human lung cancer tissues and functional blood vessels. Cancer. 2008;113:1068–79.
    1. Unsal A, Karaman CZ, Kacar F, Sen S. Atypically located pulmonary adenoid cystic carcinoma: Case report. Tuberk Toraks. 2008;56:210–4.
    1. Qiu S, Nampoothiri MM, Zaharopoulos P, Logroño R. Primary pulmonary adenoid cystic carcinoma: Report of a case diagnosed by fine-needle aspiration cytology. Diagn Cytopathol. 2004;30:51–6.
    1. Margolis ML. Non-small cell lung cancer-Clinical aspects, diagnosis, staging, and natural history. In: Fishman AP, editor. Fishman’s Pulmonary Diseases and Disorders. 3rd ed. New York: McGraw-Hill; 1998. pp. 1759–82.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe