DIAGNOSTIC YIELD OF ENDOBRONCHIAL ULTRASOUND GUIDED TRANSBRONCHIAL LUNG BIOPSY AND CRYBIOPSY IN DIAGNOSIS OF LUNG CANCER AND INTERSTITIAL LUNG DISEASES: EXPERIENCE OF KAUNO KLINIKOS

Abstract

Objective. To evaluate the diagnostic yield of interventional lung tests in diagnosis of lung cancer and interstitial lung diseases.Methods.A retrospective data analysis of 117 patients, who diagnosed peripheral lung lesions or suspected interstitial lung disease and confirmation of diagnosis was performed TBB, TBB-EBUS-RP, cryobiopsy and VATS as well. Results. TBB diagnostic yield – 46% (24/52), on the other hand, if we performed procedure with TBB-EBUS-RP the main diagnostic yield increase to 67% (35/52) (p=0.03)). In the central position of the radial probe in relation to the lesion, the diagnostic yield of TBB-EBUS-RP was significantly higher (67% (8/12)) compared to the eccentric radial probe position (21% (3/14) (p=0.02)). The diagnostic yield of cryobiopsy (73.3% (11/15)) was no significant difference in diagnostic yield of VATS (87.5% (21/24)
(p>0.05)). In all cases of VATS was made pneumothorax (100% (24/24)), which needed postoperative drainage, and only one case of pneumothorax was made after crobiopsy (6.7% (1/15) (p<0.001)). The ratio of infectious complications was also lower in patients where cryobiopsy was performed compared to patients with VATS (0% vs. 16.6% (3/24)) (p=0.09). Conclusions. Transbronchial biopsy guided EBUS-RP increase diagnostic yield from 42.3% to 67% in diagnosis of lung cancer, especially in the central position of the radial probe in relation to the lesion. The diagnostic yield of cryobiopsy in diagnosis of interstitial lung diseases is close to the gold diagnostic standard – VATS, however ratio of complications was lower in cryobiopsy.