Cryoprobe biopsy increases the diagnostic yield in endobronchial tumor lesions.
OBJECTIVE
Forceps biopsy is the standard method to obtain specimens in endoscopically visible lesions. It is common to combine forceps biopsy with cytology methods to increase the diagnostic yield. Although the flexible cryoprobe has been established for bronchoscopic interventions in malignant stenosis, the obtained biopsies, called "cryobiopsies," have not been investigated in a large cohort of patients. The aim of this feasibility study was to prospectively evaluate the diagnostic yield and safety of cryobiopsy and forceps biopsy.


METHODS
During a 6-year period, 296 patients with visible endoluminal tumor lesions were included in the study at the bronchoscopy unit of a university hospital. In the first consecutively conducted 55 cases, both techniques, forceps biopsy and cryobiopsy, were applied simultaneously. Pathologic and quantitative image analyses were performed to evaluate the size and quality of the obtained specimens. We evaluated the safety and diagnostic yield to describe the feasibility of cryobiopsy.


RESULTS
Comparative analysis of the first conducted and randomly assigned 55 cases revealed a significantly higher diagnostic yield for cryobiopsy compared with forceps biopsy (89.1% vs 65.5%, P < .05). In this cohort, quantitative image analysis showed significantly larger biopsies regarding size and artifact-free tissue sections for cryobiopsy compared with forceps biopsy (P < .0001). The overall diagnostic yield of cryobiopsy was 89.5%. Mild bleeding occurred in 11 cases (3.7%), moderate bleeding occurred in 3 cases (1.0%), and severe bleeding occurred in 1 case (0.3%).


CONCLUSIONS
Cryobiopsy is safe and increases the diagnostic yield in endobronchial tumor lesions. The method also is feasible under routine conditions.
Center of Internal Medicine, Department of Internal Medicine II, University of Ulm, Ulm, Germany. christian.schumann@uniklinik-ulm.de
Christian
C
Schumann
Jürgen
J
Hetzel
Alexander J
AJ
Babiak
Tobias
T
Merk
Thomas
T
Wibmer
Peter
P
Möller
Philipp M
PM
Lepper
Martin
M
Hetzel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001984:Bronchial Neoplasms / Q000473:pathology*; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000009:adverse effects; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013525:Surgical Instruments; D055815:Young Adult