title: Different protocols for cryobiopsy versus forceps biopsy in diagnosis of patients with endobronchial tumors.
abstract: BACKGROUND
  Forceps biopsy is the standard procedure to obtain specimens in endobronchial lesions. New studies have proposed flexible cryoprobe as an accepted alternative method for this technique. Although diagnostic use of the cryobiopsy is confirmed in few studies, there is paucity of data with regard to an optimum protocol for this method since one of the main considerations in cryobiopsy is the freezing time.
  
  
  OBJECTIVE
  To evaluate diagnostic yield and safety of endobronchial biopsies using the flexible cryoprobe. Moreover, different freezing times were assessed to propose an optimized protocol for this diagnostic modality.
  
  
  METHODS
  For each patient with a confirmed intrabronchial lesion, diagnostic o value of forceps biopsy, cryobiopsy in three seconds, cryobiopsy in five seconds and combined results of cryobiopsy in both timings were recorded.
  
  
  RESULTS
  A total of 60 patients (39 males and 21 females; Mean age 56.7 +/- 13.3) were included. Specimens that were obtained by cryobiopsy in five seconds were significantly larger than those of forceps biopsy and cryobiopsy in three seconds (p < 0.001). We showed that the achieved diagnostic yields for all three methods were not statistically different (p > 0.05). Simultaneous usage of samples produced in both cryobiopsies can significantly improve the diagnostic yield (p = 0.02). Statistical analysis showed that there were no significant differences in case of bleeding frequency among the three sampling methods.
  
  
  CONCLUSIONS
  This study confirmed safety and feasibility of cryobiopsy. Additionally, combination of sampling with two different cold induction timings would significantly increase sensitivity of this emerging technique..
authors: Tracheal Diseases Research Center, National Research Institute of Tuberlosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Hamidreza
authors: H
authors: Jabari
authors: Ramin
authors: R
authors: Sami
authors: Mohammad
authors: M
authors: Fakhri
authors: Arda
authors: A
authors: Kiani
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001706:Biopsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001984:Bronchial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001999:Bronchoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003452:Cryosurgery / Q000379:methods; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013525:Surgical Instruments