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Cryobiopsy during flex-rigid pleuroscopy: an emerging alternative biopsy method in malignant pleural mesothelioma. A comparative study of pathology
- Source :
- Japanese Journal of Clinical Oncology. 49:559-566
- Publication Year :
- 2019
- Publisher :
- Oxford University Press (OUP), 2019.
-
Abstract
- BACKGROUND Malignant pleural mesothelioma (MPM) is rarely an asbestos-related cancer with a poor prognosis that is difficult to distinguish from some benign conditions by using conventional biopsy techniques. The purpose of this study was to evaluate the utility of a novel biopsy technique using a cryoprobe during flex-rigid pleuroscopy for diagnosing MPM. METHODS Consecutive patients who underwent pleural cryobiopsy during flex-rigid pleuroscopy from June through November 2017 to diagnose the cause of pleural effusion were collected. From these, cases ultimately diagnosed as MPM were selected. Pleural biopsies were performed by using conventional instruments followed by a cryoprobe. The obtained samples were histologically examined and compared with regard to the quality (sample size, tissue depth, and crush rate), immunohistochemical (IHC) staining, and p16 by fluorescence in situ hybridization (FISH). RESULTS In total, five patients ultimately diagnosed as MPM were enrolled. The sample collected was significantly larger for cryobiopsy than conventional biopsy (18.9 mm2 vs. 6.7 mm2, P < 0.001). Full-thickness biopsies were achieved in four cases by using cryobiopsy compared with one case by conventional biopsy. Moreover, the crush rate was significantly less for cryobiopsy than conventional biopsy (9% vs. 35%, P < 0.001). The results of IHC staining and p16 by FISH were similar between biopsy techniques. Cryobiopsy successfully led to accurate diagnosis of MPM in all cases, whereas conventional biopsy was diagnostic in one case. No severe complications developed after either biopsy technique. CONCLUSION Cryobiopsy during flex-rigid pleuroscopy is a feasible and convenient biopsy technique that supports precise diagnosis of MPM.
- Subjects :
- Male
Mesothelioma
Cancer Research
medicine.medical_specialty
Poor prognosis
Lung Neoplasms
Pleural effusion
Biopsy
Pleural Neoplasms
03 medical and health sciences
0302 clinical medicine
Thoracoscopy
medicine
Humans
Radiology, Nuclear Medicine and imaging
Aged
medicine.diagnostic_test
Pleural mesothelioma
business.industry
Mesothelioma, Malignant
Cancer
General Medicine
Middle Aged
medicine.disease
Oncology
030220 oncology & carcinogenesis
Fish
Female
030211 gastroenterology & hepatology
Radiology
business
Fluorescence in situ hybridization
Subjects
Details
- ISSN :
- 14653621
- Volume :
- 49
- Database :
- OpenAIRE
- Journal :
- Japanese Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....fc1bd745fc80217a498bfab4c23f7617