Objective To evaluate the effectiveness of different biopsy methods in the diagnosis of idiopathic interstitial pneumonia (IIP).
Methods A retrospective analysis was performed in patients hospitalized and diagnosed as IIP between January 2010 to December 2013 in the Department of Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University. The patients were divided based on initial diagnoses. The performance of invasive examinations including both transbronchoscopic lung biopsy (TBLB) and surgical lung biopsy (SLB) and final diagnoses were recorded.
Results Three hundred and ninety-one patients were included in the study with mean age of 62.5±11.9 years. There were 299 patients receiving TBLB, 43 patients receiving SLB, and 49 patients receiving non-invasive examinations. Among 299 patients who underwent TBLB, parenchymal tissue was not obtained in 132 (44.1%) but successfully obtained in 167 (55.9%) patients, with 79 (47.3% out of 167) clinically helpful. TBLB-based specific diagnoses were as follows:30 cases of non-specific interstitial pneumonia (NSIP), 22 cases of cryptogenic organizing pneumonia (COP), 18 cases of idiopathic pulmonary fibrosis (IPF), 4 cases of acute interstitial pneumonia (AIP), 2 cases of respiratory bronchiolitis-interstitial lung disease (RB-ILD) and lymphocytic interstitial pneumonia (LIP) for each, 1 case of desquamative interstitial pneumonia (DIP), respectively. Among 43 patients who underwent SLB, parenchymal tissue was obtained in all cases with 40(93.0% out of 43) pathologically diagnostic, including 20 cases of NSIP, 12 cases of IPF, 3 cases of COP and LIP for each, and 2 cases of RB-ILD and DIP for each. Finally, among 181 patients who failed to obtain parenchymal tissue or did not undergo invasive examination, specific diagnoses could be established in 40 patients with all finally diagnosed as IPF.
Conclusions The pathological diagnosis, either based on TBLB or SLB, is very important in the diagnostic procedure of IIP. The biopsy technique of hospital and patient conditions should be considered when making the decision of biopsy method.
Citation：
HanQian, LuoQun, WuLulu, LiaoLiyue, ZhouYing, ChenRongchang. The Effectiveness of Different Biopsy Methods in Diagnosis of Idiopathic Interstitial Pneumonia. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(1): 64-67. doi: 10.7507/1671-6205.2015015
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- 2. MacJannette R, Fiddes J, Kerr K, et al.Is bronchoscopic lung biopsy helpful in the management of patients with diffuse lung disease? Eur Respir J, 2007, 29:1064.
- 3. Raghu G, Collard HR, Egan JJ, et al.An Official ATS/ERS/JRS/ALAT Statement:Idiopathic Pulmonary Fibrosis:Evidence-based Guidelines for Diagnosis and Management.Am J Respir Crit Care Med, 2011, 183:788-824.
- 4. Demedts M, Costabel U.ATS/ERS international multidisciplinary consensus classification of the idiopathic interstitial pneumonias.Eur Respir J, 2002, 19:794-796.
- 5. Wall C, Gaensler EA, Carrington CB, et al.Comparison of transbronchial and open biopsies in chronic infiltrative lung diseases.Am Rev Respir Dis, 1981, 123:280-285.
- 6. Berbescu EA, Katzenstein ALA, Snow JL, et al.Transbronchial biopsy in usual interstitial pneumonia.Chest, 2006, 129:1126-1131.
- 7. Poletti V, Romagnoli M, Piciucchi S, et al.Current status of idiopathic nonspecific interstitial pneumonia.Semin Respir Crit Care Med, 2012, 33:440-449.
- 8. Sato T, Fujita J, Yamadori I, et al.Non-specific interstitial pneumonia as the first clinical presentation of various collagen vascular disorders.Rheumatol Int, 2006, 26:551-555.
- 9. 徐作军, 康健.特发性间质性肺炎的新分类及思考.中华结核和呼吸杂志, 2013, 36:803-804.
