Transbronchial catheter aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer

European Journal of Medical Research

K-H Ruhle¹  G Nilius¹  K-J Franke¹ 

[1] Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, University of Witten/Herdecke, Germany

关键词: bronchoscopy;    peripheral pulmonary lesions;    trans-bronchial catheter aspiration;    transbronchial biopsy;    lung cancer;   

Others  :  1094093
DOI  :  10.1186/2047-783X-14-1-13

 received in 2008-07-14, accepted in 2008-09-26,  发布年份 2009

【 摘 要 】

Objective

The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial catheter aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy.

Methods

We analysed the results of 51 consecutively examined patients (age 68.7 ± 8.8 yrs.) applying both methods. 48 of 51 peripheral lesions proved to be malignant, 34 of which measured > 3 cm in diameter and 14 ≤ 3 cm. Fluoroscopy provided guidance in biopsies for both techniques.

Results

The mean diameter of the lesion was 3.7 ± 1.5 cm. We were able to establish a correct diagnosis by TBCA in 36 of 48 patients with lung cancer, and in 21 of 48 patients by TBB (75% vs. 44%, p < 0.01, chi-square-test). By combination of both methods 39 of 48 patients were correctly diagnosed. For carcinoma > 3 cm the success rate for TBCA was 76% (26/34) and for TBB 56% (19/34). For carcinoma ≤ 3 cm the success rate for TBCA was 71% (10/14) and for TBB 14% (2/14).

Conclusions

Even in lesions ≤ 3 cm application of TBCA results in an only marginally lower success rate compared to lesions > 3 cm. Due to the overall high success rate we suggest to apply the easy-to-handle and inexpensive method of TBCA in diagnostic procedure of peripheral lung carcinoma.

【 授权许可】

   
2009 I. Holzapfel Publishers

【 参考文献 】

• [1]Reichenberger F, Weber J, Tamm M, Bolliger CT, Dalquen P, Perruchoud AP, Solèr M: The value of transbronchial needle aspiration in the diagnosis of peripheral pulmonary lesions. Chest 1999, 116:704-708.
• [2]Baaklini WA, Reinoso MA, Gorin AB, Sharafkaneh A, Manian P: Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest 2000, 117:1049-1054.
• [3]Mak VHF, Johnston IDA, Hetzel MR, Grubb C: Value of washings and brushings at fibreoptic bronchoscopy in the diagnosis of lung cancer. Thorax 1990, 45:373-376.
• [4]Chechani V: Bronchoscopic diagnosis of solitary pulmonary nodules and lung masses in the absence of endobronchial abnormality. Chest 1996, 109:620-625.
• [5]Bilaceroglu S, Kumcuoglu Z, Alper H, Osma E, Cagirici U, Gunel O, Bayol U, Celikten E, Perim K, Kose T: CT bronchus sign-guided bronchoscopic multiple diagnostic procedures in carcinomatous solitary pulmonary nodules and masses. Respiration 1998, 65:49-55.
• [6]Katis K, Inglesos E, Zachariadis E, Palamidas P, Paraskevopoulos I, Sideris G, Tamvakopoulou E, Apostolopoulou F, Rasidakis A: The role of transbronchial needle aspiration in the diagnosis of peripheral lung masses or nodules. Eur Respir J 1995, 8:963-966.
• [7]Gasparini S, Ferretti M, Secchi EB, Baldelli S, Zuccatosta L, Gusella P: Integration of transbronchial and percutaneous approach in the diagnosis of peripheral pulmonary nodules or masses. Chest 1995, 108:131-137.
• [8]Lee C-H, Wang C-H, Lin M-C, Tsao TCY, Lan R-S, Tsai Y-H, Kuo H-P: Multiple brushings with immediate Riu's stain via flexible fibreoptic bronchoscopy without fluoroscopic guidance in the diagnosis of peripheral pulmonary tumours. Thorax 1995, 50:18-21.
• [9]Agusti C, Xaubet A, Monton C, Sole M, Soler N, Carrion M, Rodriguez Roisin R: Induced sputum in the diagnosis of peripheral lung cancer not visible endoscopically. Respir Med 2001, 10:822-882.
• [10]Liao W-Y, Jerng J-S, Chen K-Y, Chang Y-L, Yang P-C, Kuo S-H: Value of imprint cytology for ultrasound-guided transthoracic core biopsy. Eur RespirJ 2004, 24:905-909.
• [11]Friedel H: Die Katheterbiopsie des peripheren Lungenherdes. Tuberkulosebibliothek Nr99 Barth, Leipzig 1961.
• [12]Atay Z, Hammesfahr R, Worch R, Ekinci C: Cytological diagnosis of peripheral lung tumours by combined evaluation of catheter and aspiration biopsies. Prax Pneumol 1981, 35:220-224.
• [13]Kurimoto N, Miyazawa T, Okimasa S, Maeda A, Oiwa H, Miyazu Y, Murayama M: Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest 2004, 126:959-965.
• [14]Herth FJF, Ernst A, Becker HD: Endobronchial ultrasound-guided transbronchial lung biopsy in solitary pulmonary nodules and peripheral lesions. Eur Respir J 2002, 20:972-974.
• [15]Herth FJF, Eberhardt R, Becker HD, Ernst A: Endobronchial ultrasound-guided transbronchial lung biopsy in fluoroscopically invisible solitary pulmonary nodules - a prospective trial. Chest 2006, 129:147-150.
• [16]Gildea TR, Mazzone PJ, Karnak D, Meziane M, Mehta AC: Electromagnetic navigation diagnostic bronchoscopy - a prospective study. Am J Respir Crit Care Med 2006, 174:982-989.
• [17]Franke KJ, Nilius G, Ruehle KH: Transbronchial biopsy in comparison with catheter aspiration in the diagnosis of peripheral pulmonary nodules. Pneumologie 2006, 60:7-10.
• [18]Torrington KG, Kern JD: The utility of fiberoptic bronchoscopy in the evaluation of the solitary pulmonary nodule. Chest 1993, 104:1021-1024.
• [19]Haponik EF, Shure D: Underutilization of transbronchial needle aspiration: experiences of current pulmonary fellows. Chest 1997, 112:251-253.
• [20]Franke KJ, Nilius G, Rühle KH: Frequency of cytological procedures in diagnostic bronchoscopy of peripheral pulmonary nodules and masses. Pneumologie 2006, 60:663-666.
• [21]Shure D: Transbronchial biopsy and needle aspiration. Chest 1989, 95:1130-1138.
• [22]Yoshikawa M, Sukoh N, Yamazaki K, Kanazawa K, Fukumoto S, Harada M, Kikuchi E, Munakata M, Nishimura M, Isobe H: Diagnostic value of endobronchial ultrasonography with a guide sheath for peripheral pulmonary lesions without x-ray fluoroscopy. Chest 2007, 131:1788-1793.
• [23]Eberhardt R, Anantham D, Herth F, Feller-Kopman D, Ernst A: Electromagnetic navigation diagnostic bronchoscopy in peripheral lung lesions. Chest 2007, 131:1800-1805.
• [24]Eberhardt R, Anantham D, Ernst A, Feller-Kopman D, Herth F: Multimodality bronchoscopic diagnosis of peripheral lung lesions. Am J Respir Crit Care Med 2007, 176:36-41.