Application Value Of Transbronchial Cryobiopsy In The Diagnosis Of Interstitial Lung Disease:a Meta-analysis

Objective:To systematically evaluate the diagnostic value and safety of transbronchial cryobiopsy compared with transbronchial forceps biopsy in the diagnosis of interstitial lung diseases,in order to provide evidence for the pathological diagnosis of interstitial lung diseases.Methods:In the computer search and retrieval of CNKI,wanfang database,viper database,the Cochrane Library,PubMed,Embase,we searched for clinical studies on the comparison of transbronchial cryobiopsy and transbronchial forceps biopsy.The search time was from the establishment of the datebase to February 2020.Screening literature according to inclusion and exclusion criteria,then the quality evaluation and data extraction of the included literature were carried out,and Meta analysis was carried out with RevMan 5.3software and Stata 15 software.Results:A total of 8 studies were included,including 979 cases in the transbronchial cryobiopsy group and 963 cases in the transbronchial forceps biopsy group.MetaAnalysis results show :Compared with transbronchial forceps biopsy,specimens undergoing transbronchial cryobiopsy were larger(MD=9.94,95%CI(8.19,11.70),P<0.00001),with a higher diagnostic rate(RR=1.54,95%CI(1.31,1.82),P<0.00001),a higher risk of bleeding(RR=1.52,95%CI(1.35,1.72),P<0.00001),a higher risk ofmoderate to severe bleeding(RR=1.84,95%CI(1.23,2.76),P=0.003),and a higher risk of pneumothorax(RR=1.99,95%CI(1.08,3.65),P=0.03).In addition,the diagnostic rate of TBCB was 67%(ES=0.67,95%CI(0.59,0.75)),the incidence of bleeding was63%(ES=0.63,95%CI(0.43,0.82)),the incidence of moderate to severe bleeding was13%(ES=0.13,95%CI(0.05,0.24)),and the incidence of pneumothorax was 6%(ES=0.06,95%CI(0.04,0.08)).Conclusion:In the pathological diagnosis of interstitial lung disease,transbronchial cryobiopsy has a higher diagnostic rate than transbronchial forceps biopsy,and is also associated with a higher risk of bleeding and pneumothorax.However,the complications of transbronchial cryobiopsy are generally controllable,which is a relatively safe operation and worthy of clinical promotion.