title: Cryobiopsy increases the diagnostic yield of endobronchial biopsy: a multicentre trial.
abstract: Forceps, brushes or needles are currently the standard tools used during flexible bronchoscopy when diagnosing endobronchial malignancies. The new biopsy technique of cryobiopsy appears to provide better diagnostic samples. The aim of this study was to evaluate cryobiopsy over conventional endobronchial sampling. A total of 600 patients in eight centres with suspected endobronchial tumours were included in a prospective, randomised, single-blinded multicentre study. Patients were randomised to either sampling using forceps or the cryoprobe. After obtaining biopsy samples, a blinded histological evaluation was performed. According to the definitive clinical diagnosis, the diagnostic yield for malignancy was evaluated by a Chi-squared test. A total of 593 patients were randomised, of whom 563 had a final diagnosis of cancer. 281 patients were randomised to receive endobronchial biopsies using forceps and 282 had biopsies performed using a flexible cryoprobe. A definitive diagnosis was achieved in 85.1% of patients randomised to conventional forceps biopsy and 95.0% of patients who underwent cryobiopsy (p<0.001). Importantly, there was no difference in the incidence of significant bleeding. Endobronchial cryobiopsy is a safe technique with superior diagnostic yield in comparison with conventional forceps biopsy.
authors.affiliation: Dept of Internal Medicine II, University of Tuebingen, Tuebingen, Germany. juergen.Hetzel@med.uni-tuebingen.de
authors.forename: J
authors.initials: J
authors.lastname: Hetzel
authors.forename: R
authors.initials: R
authors.lastname: Eberhardt
authors.forename: F J F
authors.initials: FJ
authors.lastname: Herth
authors.forename: C
authors.initials: C
authors.lastname: Petermann
authors.forename: G
authors.initials: G
authors.lastname: Reichle
authors.forename: L
authors.initials: L
authors.lastname: Freitag
authors.forename: I
authors.initials: I
authors.lastname: Dobbertin
authors.forename: K J
authors.initials: KJ
authors.lastname: Franke
authors.forename: F
authors.initials: F
authors.lastname: Stanzel
authors.forename: T
authors.initials: T
authors.lastname: Beyer
authors.forename: P
authors.initials: P
authors.lastname: Möller
authors.forename: P
authors.initials: P
authors.lastname: Fritz
authors.forename: G
authors.initials: G
authors.lastname: Ott
authors.forename: P A
authors.initials: PA
authors.lastname: Schnabel
authors.forename: H
authors.initials: H
authors.lastname: Kastendieck
authors.forename: W
authors.initials: W
authors.lastname: Lang
authors.forename: A T
authors.initials: AT
authors.lastname: Morresi-Hauf
authors.forename: M N
authors.initials: MN
authors.lastname: Szyrach
authors.forename: R
authors.initials: R
authors.lastname: Muche
authors.forename: P L
authors.initials: PL
authors.lastname: Shah
authors.forename: A
authors.initials: A
authors.lastname: Babiak
authors.forename: M
authors.initials: M
authors.lastname: Hetzel
mesh_terms: D000368:Aged; D001706:Biopsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001999:Bronchoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis*; D013525:Surgical Instruments / Q000009:adverse effects