Cryobiopsy: should this be used in place of endobronchial forceps biopsies?
Forceps biopsies of airway lesions have variable yields. The yield increases when combining techniques in order to collect more material. With the use of cryotherapy probes (cryobiopsy) larger specimens can be obtained, resulting in an increase in the diagnostic yield. However, the utility and safety of cryobiopsy with all types of lesions, including flat mucosal lesions, is not established.


OBJECTIVE
Demonstrate the utility/safety of cryobiopsy versus forceps biopsy to sample exophytic and flat airway lesions.


METHODS
Teaching hospital-based retrospective analysis.


METHODS
Retrospective analysis of patients undergoing cryobiopsies (singly or combined with forceps biopsies) from August 2008 through August 2010. Statistical Analysis. Wilcoxon signed-rank test.


RESULTS
The comparative analysis of 22 patients with cryobiopsy and forceps biopsy of the same lesion showed the mean volumes of material obtained with cryobiopsy were significantly larger (0.696 cm(3) versus 0.0373 cm(3), P = 0.0014). Of 31 cryobiopsies performed, one had minor bleeding. Cryopbiopsy allowed sampling of exophytic and flat lesions that were located centrally or distally. Cryobiopsies were shown to be safe, free of artifact, and provided a diagnostic yield of 96.77%.


CONCLUSIONS
Cryobiopsy allows safe sampling of exophytic and flat airway lesions, with larger specimens, excellent tissue preservation and high diagnostic accuracy.
Section of Pulmonary, Critical Care, Environmental and Sleep Medicine, Virginia Tech Carilion School of Medicine-Carilion Clinic, Roanoke, VA 24014, USA.
Edmundo R
ER
Rubio
Susanti R
SR
le
Ralph E
RE
Whatley
Michael B
MB
Boyd
D001706:Biopsy / Q000379:methods*; D003452:Cryosurgery / Q000379:methods*; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013048:Specimen Handling; D013525:Surgical Instruments