Abstract
Background: It is very difficult to obtain samples of peripheral pulmonary ground-glass opacity lesions (GGOs) by traditional transbronchial biopsy. This study was conducted to evaluate the diagnostic efficacy and safety of transbronchial cryobiopsy (TBCB) for GGOs by a newly developed ultrathin cryoprobe whose outer diameter was 1.1 mm.Methods: Twenty patients with 23 GGOs received TBCB using the ultrathin cryoprobe were retrospectively analyzed from October 2018 to November 2019 in Shanghai Chest Hospital. TBCB was performed under the guidance of virtual bronchoscopic navigation (VBN), electromagnetic navigation bronchoscopy (ENB), endobronchial ultrasound and fluoroscopy. We collected baseline information of subjects, reported diagnostic yield and complications, analyzed factors may affect the diagnostic yield.Results: Twenty-three GGOs (12 pure GGOs, 11 mixed GGOs), with an average diameter of 21.58 ± 11.88mm, received TBCB and the diagnostic yield was 82.61% (19/23). Of the 19 GGOs diagnosed by TBCB, 12 were adenocarcinoma, 5 were inflammation, one was occupational interstitial lung disease, one was pulmonary meningothelial-like nodule. The undiagnosed 4 lesions confirmed to be adenocarcinomas by further analysis. None of the factors, including size (GGOs ≥ 20mm, GGOs < 20mm), navigation (VBN, ENB), fluoroscopic visibility (visible, invisible), GGO-component (pure GGOs, mixed GGOs) and guide sheath (K-201, K203), changed the diagnostic yield. No pneumothorax or severe hemorrhage presented.Conclusions: The ultrathin cryoprobe is feasible and safe for the diagnosis of pulmonary GGOs with high diagnostic yield, which provided a huge potential tool for the diagnosis of GGOs, especially for those suspicious of early-stage lung cancer.Trial registration: Clinical Trials.gov. No: NCT03716284. Registered: 20 October, 2018. URL: Clinical Trials.gov.