Advertisement

Surgical Endoscopy

, Volume 31, Issue 3, pp 1219–1224 | Cite as

How many samples would be optimal for endobronchial cryobiopsy?

  • Fatih SegmenEmail author
  • Zafer Aktaş
  • Ayperi Öztürk
  • Derya Kızılgöz
  • Aydın Yılmaz
  • Ibrahim Onur Alıcı
  • Funda Demirağ
  • Polat Pehlivanoğlu
Article

Abstract

Background

Cryobiopsy, which provides larger specimens without crush artifact, is a good option for the diagnosis of visible endobronchial tumors. While there are several papers on diagnostic performance, application protocols vary between centers. In this study, we aimed to find the optimal number of cryobiopsies in endobronchial tumors.

Methods

We prospectively involved cases with a visible endobronchial tumor in which conventional diagnostic measures failed and/or a therapeutic interventional bronchoscopy was planned. Endobronchial tumor was visualized, and four cryobiopsies were taken with a dedicated flexible probe. The samples were evaluated by a pathologist who was blinded to the order of the biopsies. The cumulative performances of one to four cryobiopsies were compared, and a complication analysis was conducted.

Results

A total of 50 patients were involved. Four cryobiopsies were taken from 49 patients, and a single biopsy was taken from one case. The sensitivities of one, two, three and four biopsies were 82, 93.9, 93.9 and 95.9 %, respectively. The difference in performance of one and two biopsies was significant (p = 0.031), but the third and fourth biopsies were found to be unnecessary (p = 1.0 for second versus third and p = 1.0 for second versus fourth). Bleeding risk increased when ≥3 cryobiopsies were taken (Odds Ratio 2.758).

Conclusions

When the diagnostic benefits and complication rates were considered, two cryobiopsies were found to be optimal for endobronchial tumors. In patients with non-diagnostic conventional bronchoscopy, endobronchial tumors may be diagnosed by cryobiopsy.

Keywords

Cryobiopsy Endobronchial Lung cancer Bronchoscopy 

Notes

Acknowledgments

Fatih Segmen is the guarantor of the content of the manuscript, including the data and analysis. FS, AA, AÖ, DK, AY, IOA, FD and PP contributed substantially to the study design, data analysis and interpretation, and the writing of the manuscript

Compliance with ethical standards

Disclosures

Fatih Segmen, Aydın Yılmaz, Zafer Aktaş, Ayperi Öztürk, Derya Kızılgöz, Ibrahim Onur Alıcı, Funda Demirağ, Polat Pehlivanoğlu declare that there are no conflicts of interests and they did not use any kind of funding or grants.

References

  1. 1.
    Schreiber G, McCrory D (2003) Performance characteristics of different modalities for diagnosis of suspected lung cancer. Summary of published evidence. Chest 123:115S–128SCrossRefPubMedGoogle Scholar
  2. 2.
    Rivera MP, Mehta AC (2007) Initial diagnosis of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 132(3):131–148CrossRefGoogle Scholar
  3. 3.
    Du Rand IA, Barber PV, Goldring J et al (2011) British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax 66:1–21Google Scholar
  4. 4.
    Hetzel J, Eberhardt R, Herth FJ et al (2012) Cryobiopsy increases the diagnostic yield of endobronchial biopsy: a multicentre trial. Eur Respir J 39(3):685–690CrossRefPubMedGoogle Scholar
  5. 5.
    Aktas Z, Gunay E, Taci Hoca N et al (2010) Endobronchial cryobiopsy or forceps biopsy for lung cancer diagnosis. Ann Thorac Med. 5(4):242–246CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Schumann C, Hetzel J, Babiak AJ et al (2010) Cryoprobe biopsy increases the diagnostic yield in endobronchial tumor lesions. J Thorac Cardiovasc Surg 140(2):417–421CrossRefPubMedGoogle Scholar
  7. 7.
    Mobarak IS, Eel-Zahraa F, El-Deen S (2011) Diagnostic yield of cryobiopsy and forceps biopsy in visible endobronchial lung tumors: a comparative study. Egypt J Bronchol 5(1):26–32Google Scholar
  8. 8.
    Franke KJ, Theegarten D, Hannvon Weyhern C et al (2010) Prospective controlled animal study on biopsy sampling with new flexible cryoprobes versus forceps: evaluation of biopsy size, histological quality and bleeding risk. Respiration 80(2):127–132CrossRefPubMedGoogle Scholar
  9. 9.
    Jabari H, Sami R, Fakhri M, Kaini A (2012) Different protocols for cryobiopsy versus forceps biopsy in diagnosis of patients with endobronchial tumors. Pneumologia 61(4):230–233PubMedGoogle Scholar
  10. 10.
    Rubio ER, Susanti R, Whatley RE, Boyd MB (2013) Cryobiopsy: should this be used in place of endobronchial forceps biopsies? Bio Med Res Int 2013:730574. doi: 10.1155/2013/730574 Google Scholar
  11. 11.
    Schumann C, Hetzel M, Babiak AJ et al (2010) Endobronchial tumor debulking with a flexible cryoprobe for immediate treatment of malignant stenosis. J Thorac Cardiovasc Surg 139:997–1000CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Fatih Segmen
    • 1
    Email author
  • Zafer Aktaş
    • 2
  • Ayperi Öztürk
    • 2
  • Derya Kızılgöz
    • 3
  • Aydın Yılmaz
    • 2
  • Ibrahim Onur Alıcı
    • 4
  • Funda Demirağ
    • 5
  • Polat Pehlivanoğlu
    • 6
  1. 1.Intensive Care UnitAtatürk Chest Diseases and Thoracic Surgery Education and Research HospitalAnkaraTurkey
  2. 2.Interventional Pulmonology ClinicAtatürk Chest Diseases and Thoracic Surgery Education and Research HospitalAnkaraTurkey
  3. 3.Palliative Care UnitAtatürk Chest Diseases and Thoracic Surgery Education and Research HospitalAnkaraTurkey
  4. 4.Pulmonary MedicineDr.Suat Seren Chest Diseases and Thoracic Surgery Education and Research HospitalİzmirTurkey
  5. 5.Department of PathologyAtatürk Chest Diseases and Thoracic Surgery Education and Research HospitalAnkaraTurkey
  6. 6.AnesthesiologyUşak City HospitalUşakTurkey

Personalised recommendations