Chest:胸膜冷冻活检

2019-11-29 xiangting MedSci原创

根据对较一致观察性数据的分析,胸膜冷冻活检是安全的,但与钳子活检相比,诊断率并没有提高。

使用视频辅助胸腔镜手术或医学胸腔镜进行胸膜活检是目前胸膜病理学的诊断标准,但诊断率不高。冷冻活检可以提供更大的组织,增加采样组织的深度,和/或减少碎片。然而,冷冻活检对诊断率的影响仍不明确,并且其安全性也存在潜在问题。针对这些问题进行了一项系统评价和荟萃分析。

研究人员对MEDLINEEmbase和谷歌学术进行了系统检索,查找评估胸膜冷冻活检性能的研究,并使用质量评估、数据提取和合成-2工具评估每项研究的质量。使用逆方差加权对估算诊断率进行了荟萃分析。研究还分析了样本特征和手术相关并发症。

评价了7项观察性研究,涉及586例胸膜活检(311例冷冻活检和275例挠性钳活检)。除1项研究外,所有研究均使用半刚性胸腔镜。荟萃分析显示冷冻活检的诊断率为96.5%,钳子活检的诊断率为93.1%,逆方差加权OR1.6195CI0.71-3.66),I216%。没有报道冷冻活检有中至重度出血的情况。漏斗图表明没有明显的出版倾向性。

根据对较一致观察性数据的分析,胸膜冷冻活检是安全的,但与钳子活检相比,诊断率并没有提高。进一步研究需要足够权重的多中心随机试验。

原始出处:

Majid Shafiq. Pleural Cryobiopsy A Systematic Review and Meta-Analysis. Chest. October 2019.

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    2020-10-25 Smile2680
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    2020-10-23 lifestar
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