Forceps biopsy and cryobiopsy equally effective for diagnosing lung lesions
Forceps biopsy and cryobiopsy are recently recognised as innovative auxiliary techniques to EBUS-TBNA for mediastinal sampling. Nevertheless, it remains unclear which of the two techniques is the superior match for standard needle biopsy.
EBUS-TBNA(Endobronchial ultrasound-guided transbronchial needle aspiration) is the standard for lung cancer staging, but due to retrieval of limited tissue, its diagnostic utility may be hampered. Recent evidence suggests forceps biopsy and cryobiopsy as auxiliary techniques for larger diagnostic samples.
According to a study published in Pulmonology, “Transbronchial mediastinal cryobiopsy might be a promising tool to supplement traditional needle biopsy for increased diagnostic yield and tissue harvesting.”
This study aimed to assess the usefulness of forceps biopsy and cryobiopsy in diagnosing mediastinal diseases. Patients with 1 cm or more lesions were enrolled, and after needle aspiration, three forceps biopsies and one cryobiopsy were performed randomly. The primary outcomes were diagnostic yield (percentage of patients with a definite diagnosis) and complications related to the procedure.
Key results of this study are:
· A total of 155 patients were enrolled in the study and assigned randomly.
· The addition of either forceps biopsy or cryobiopsy to EBUS-TBNA led to an increased diagnostic yield, with no significant difference between the two methods (EBUS-TBNA plus forceps biopsy and EBUS-TBNA plus cryobiopsy (85.7 % versus 91.6 %).
· However, samples obtained through cryobiopsy were more suitable for lung cancer molecular testing than forceps biopsy samples (100.0 % versus 89.5 %).
· Overall, the diagnostic yield of cryobiopsy was superior to forceps biopsies (85.7 % versus 70.8 %).
· Cryobiopsies also produced more samples in a shorter time than forceps biopsies.Two cases of postprocedural pneumothorax were identified.
Our results suggest that mediastinal cryobiopsy might be a suitable complementary approach to traditional needle sampling, they said.
Reference:
Tian, C. et al. Comparison of cryobiopsy and forceps biopsy for the diagnosis of mediastinal lesions: A randomised clinical trial. Pulmonology.
