Abstract:

Objective To investigate the diagnostic value of ultrasound-guided bronchoscopic cryobiopsy in diagnosing peripheral lung nodule. Methods From January 2019 to January 2021, 97 patients whose chest CT test showed lung nodules (8 mm < nodule diameter ≤30 mm) and then took electric bronchoscope were enrolled in He’nan Provincial People’s Hospital. Random number table method was used to allocate them into cryobiopsy group (TBCB group; 47 patients) and conventional forceps biopsy group (TBLB group; 50 patients). The difference of diagnosis rate, operation time, tissue sample satisfaction and complication occurrence between the two methods were observed. Results Diagnostic rate of TBCB group was 87.2% (41/47), significantly higher than the TBLB group (70.0%, 35/50; χ ²=4.240, P=0.039). Average total operating time of TBCB group was (32.5±11.2) min, no significant difference was observed compared with TBLB group ((34.2±10.3) min, t=0.938, P=0.351). Tissue sample satisfaction rate of TBCB group was 87.2% (41/47), significantly higher than the TBLB group (56.0%, 28/50; χ ²=11.510, P<0.001). All patients were able to tolerate bronchoscopy, no serious adverse reactions such as chest tightness, chest pain occurred. Thirteen (27.7%, 13/47) patients in the TBCB group had a mild to moderate amount of bleeding, while the TBLB group had 5 (10.0%, 5/50) patients experienced this. All of them stopped bleeding after receiving balloon occlusion, suction or local medication. The incidence of bleeding in TBCB group was significantly higher than the TBLB group (χ ²=4.999, P=0.025). Conclusion Cryobiopsy could be used to improve the positive rate of peripheral nodule diagnosis. The most common complication caused by cryobiopsy was bleeding, it should be performed with a preset balloon or using rigid bronchoscope sheath.

Key words: Bronchoscopy, Biopsy, Lung neoplasms, Diagnosis