Efficacy and Safety of Transbronchial Cryobiopsy in the Etiologic Diagnosis of Interstitial Lung Disease

Objective To investigate the efficacy and safety of transbronchial cryobiopsy （TBCB） in the diagnosis of interstitial lung disease （ILD）. Methods Between August 2018 to June 2020, 25 patients with ILD were included, all patients met the inclusion criteria for TBCB in Guangdong Provincial People's Hospital, all of them consented to undergo TBCB by flexible bronchoscope. Histopathological and microbiological evaluations were performed on the tissues obtained from the patients. The diagnosis was made according to the result of TBCB and multidisciplinary team （MDT）, and treatments were conducted on the basis of TBCB diagnosis. The complications of TBCB were recorded as well. Results 25 patients underwent TBCB by flexible bronchoscope. The operation time of TBCB spanned 20~30 mins on average, the median number of biopsy tissues was 3 （1,5）, and the median area of tissues was 15 （2,38） mm². 25 patients were diagnosed definitely in which 19 patients acquired the specific etiology classification. Diagnostic yield of accurate etiological classification was 76% （19/25）. Pneumothorax occurred in 7 patients （4 patients mild, 1moderate and 2severe） and all those patients relived by medical conservative treatment, thoracic puncture or pleural drainage. Bleeding occurred in all 25 patients （8 patients in grade 1, 7 in grade 2, 10 in grade 3, 0 in grade 4） and all were controlled by implementing coagulation measures. According to the diagnoses acquired by cryobiopsy, proper treatments were conducted. 4（18%） patients were cured, 18 （72%） patients were alleviated, 3 （12%） patients were stable and no patients deteriorated. Conclusions TBCB has good diagnostic value which can acquire enough specimen with minor damage, less complication and high security. It is an effective method for the pathological diagnosis of ILD.