Diagnostic value of sheath-guided frozen biopsy technique for drug-induced interstitial lung disease

Abstract

Purpose: To investigate the diagnostic value of sheath-guided frozen biopsy technique for interstitial lung disease (ILD). Methods: In this retrospective study, 48 ILD patients of exclusive etiology admitted to Xi’an International Medical Center Hospital between October 1,  2021, and May 31, 2022, were randomly assigned to receive either endobronchial ultrasound with a guide sheath combined with transbronchial cryobiopsy TBCB (TBCB group), or endobronchial ultrasound with a guide sheath combined with transbronchial lung biopsy TBLB (TBLB group). Results: The two groups were well-balanced in terms of baseline profiles (p = 0.94). The mean size of tissue blocks was 24.45 ± 2.83 mm2 in TBCB group  and 3.58 ± 0.89 mm2 in TBLB group. TBCB and TBLB groups presented with a diagnostic accuracy of 64.00 % (16/25) and 69.57 % (16/23), respectively,  while chi-square test demonstrated no significant difference between the two groups (p = 0.683). Chi-square test showed that there was significant  difference in the incidence of complications (p = 0.036) as well as the incidence of bleeding (p = 0 .045), but no significant difference in the incidence of  pneumothorax between the two groups (p = 0.605). Conclusion: There are no significant differences in diagnostic sensitivity, specificity, and accuracy between endobronchial ultrasound sheath-guided  frozen lung tissue biopsy and conventional clamped lung tissue biopsy for ILD, but the former has a lower incidence of complication than the latter. It is   necessary to conduct a larger clinical study to further validate these findings.