Integration of cryobiopsies for interstitial lung disease diagnosis is a valid and safe diagnostic strategy—experiences based on 250 biopsy procedures

Kronborg-White, Sissel; Sritharan, Sophia Sajitha; Madsen, Line Bille; Folkersen, Birgitte Holst; Voldby, Nina; Poletti, Venerino; Rasmussen, Torben Riis; Bendstrup, Elisabeth

doi:10.21037/jtd-20-2431

Cited by 13 publications

(17 citation statements)

References 25 publications

(68 reference statements)

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“…However, those with an enhanced coughing tendency may have coughed more after the procedure, thus increasing the risk of pneumothorax. Similarly, the authors of a recent study pondered the relevance of coughing during extubation in the risk of pneumothorax occurrence [36]. The association between low LCQ score and the risk of pneumothorax could theoretically be explained in two ways.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors of clinically significant complications in transbronchial lung cryobiopsy: A prospective multi-center study

Mononen

Saari

Hasala

et al. 2022

Respiratory Medicine

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Section: Discussionmentioning

confidence: 99%

“…One patient died possibly due to an acute exacerbation within 90 days after the TBLC. Previous studies have reported mortality rates in 30-day [7][8][9]15,18], 60-day [13], or 90-day [18,36,39] intervals. Several studies have not reported any time interval for their 0% mortality rates [5,6,10,11,14,16].…”

Section: Discussionmentioning

confidence: 99%

Risk factors of clinically significant complications in transbronchial lung cryobiopsy: A prospective multi-center study

Mononen

Saari

Hasala

et al. 2022

Respiratory Medicine

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“…In a large retrospective study of 1024 patients with localized lung lesions who were placed under general anesthesia for cryobiopsy using both a rigid and a flexible bronchoscope, the frequency of moderate to severe bleeding was 8.5% [ 10 ]. In most cases, bleeding is controllable with bronchoscopy, however, near-fatal bleeding has been reported in rare cases [ 19 , 20 ]. In addition, soiling of the airways with blood may exacerbate diffuse lung disease [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Thin bronchoscopic cryobiopsy using a nasobronchial tube

et al. 2022

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Background Transbronchial lung cryobiopsy is useful when diagnosing lung lesions. However, prevention of associated bleeding complications is essential. This study aimed to evaluate the safety and efficacy of our novel bronchoscopic cryobiopsy technique, which uses a long nasobronchial tube to prevent blood flooding the central airway. Methods Patients with localized or diffuse lung lesions were prospectively enrolled and underwent cryobiopsy using a 1.9 mm diameter cryoprobe and a 4.0 mm diameter thin bronchoscope under conscious sedation. For cryobiopsy, a long silicone tube (inner diameter, 5.0 mm) was advanced through the nose to the target bronchus, then wedged to drain blood under thin-tube bronchoscopic control. The primary endpoint was the frequency of bleeding complications. Results Of the 80 patients initially enrolled, 73 that underwent at least one cryobiopsy were ultimately included. Mild bleeding during cryobiopsy occurred in 58 patients (79.5%), but there was no moderate or severe bleeding. Other complications occurred in four patients (two pneumothorax, one pneumomediastinum, and one pneumonia). Tube dislocation was noted in eight patients (11%). Cryobiopsy specimens were significantly larger than forceps biopsy specimens (9.0 mm2 vs. 2.7 mm2, P < .001) and allowed specific diagnoses in 50 patients (68.5%). Conclusions Thin bronchoscopic cryobiopsy using a nasobronchial tube in consciously sedated patients is safe and effective. Trial registration Date of registration: 24/06/2019. UMIN-Clinical Trials Registry; Identifier: UMIN000037156 https://www.umin.ac.jp/ctr/index.htm

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“…The cryobiopsy procedure was performed as previously described [ 29 ]. Patients were under general anesthesia using propophol, remifenthanyl and rocuronium and intubated with a Rusch orotracheal tube.…”

Section: Methodsmentioning

confidence: 99%

PD-L1 Expression in Patients with Idiopathic Pulmonary Fibrosis

Kronborg-White

Madsen

Bendstrup

et al. 2021

JCM

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Background: Idiopathic pulmonary fibrosis (IPF) is the most common and severe form within the group of idiopathic interstitial pneumonias. It is characterized by repetitive alveolar injury in genetically susceptible individuals and abnormal wound healing, leading to dysregulated bronchiolar proliferation and excessive deposition of extracellular matrix, causing complete architectural distortion and fibrosis. Epithelial-to-mesenchymal transition is considered an important pathogenic event, a phenomenon also observed in various malignant neoplasms, in which tumor cells express programmed death-ligand one (PD-L1). The aim of this study was to assess the presence of PD-L1 in patients with IPF and other interstitial lung diseases (ILDs). Method: Patients with a clinically and radiologically suspected idiopathic interstitial pneumonia or other ILDs undergoing transbronchial cryobiopsy to confirm the diagnosis at the Department of Respiratory Diseases and Allergy, Aarhus University Hospital, were included in this prospective observational study. Cellular membrane PD-L1 expression in epithelial cells was determined using the DAKO PD-L1 IHC 22C3 PharmDx Kit. Results: Membrane-bound PD-L1 (mPD-L1) was found in twelve (28%) of the forty-three patients with IPF and in five (9%) of the fifty-five patients with other ILDs (p = 0.015). When adjusting for age, gender and smoking status, the odds ratio of having IPF when expressing mPD-L1 in alveolar and/or bronchiolar epithelial cells was 4.3 (CI: 1.3–14.3). Conclusion: Expression of mPD-L1 in epithelial cells in the lung parenchymal zones was detected in a consistent subgroup of patients with IPF compared to other interstitial pneumonias. Larger studies are needed to explore the role of mPD-L1 in patients with IPF.

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Integration of cryobiopsies for interstitial lung disease diagnosis is a valid and safe diagnostic strategy—experiences based on 250 biopsy procedures

Cited by 13 publications

References 25 publications

Risk factors of clinically significant complications in transbronchial lung cryobiopsy: A prospective multi-center study

Risk factors of clinically significant complications in transbronchial lung cryobiopsy: A prospective multi-center study

Thin bronchoscopic cryobiopsy using a nasobronchial tube

PD-L1 Expression in Patients with Idiopathic Pulmonary Fibrosis

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