BACKGROUND Transbronchial cryobiopsy (TBC) is increasingly recognized as a potential alternative to surgical lung biopsy (SLB) for the diagnosis of interstitial lung disease (ILD). The goal of this analysis was to examine the literature on TBC as it relates to diagnostic utility and safety to provide evidence-based and expert guidance to clinicians. METHODS Approved panelists developed key questions regarding the diagnostic utility and safety of TBC for the evaluation of ILD using the PICO (population, intervention, comparator, and outcome) format. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion and vetted evaluation tools were used to assess the quality of included studies, to extract data, and to grade the level of evidence supporting each recommendation or statement. Graded recommendations and ungraded consensus-based statements were drafted and voted on using a modified Delphi technique to achieve consensus. RESULTS The systematic review and critical analysis of the literature based on 4 PICO questions resulted in 6 statements: 2 evidence-based graded recommendations and 4 ungraded consensus-based statements. CONCLUSIONS Evidence of the utility and safety of TBC for the diagnosis of ILD is limited but suggests TBC is safer than SLB and its contribution to the diagnosis obtained via multidisciplinary discussion is comparable to that of SLB, although the histologic diagnostic yield appears higher with SLB (approximately 80% for TBC VS. 95% for SLB). Additional research is needed to enhance knowledge regarding utility and safety of TBC, its role in the diagnostic algorithm of ILD, and the impact of technical aspects of the procedure on diagnostic yield and safety.

中文翻译：

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经支气管冷冻活检诊断间质性肺疾病：CHEST 指南和专家小组报告

背景技术经支气管冷冻活检（TBC）越来越被认为是用于诊断间质性肺病（ILD）的外科肺活检（SLB）的潜在替代方法。该分析的目的是检查有关 TBC 的文献，因为它与诊断效用和安全性有关，以便为临床医生提供循证和专家指导。方法 经批准的小组成员提出了关于 TBC 使用 PICO（人群、干预、比较和结果）格式评估 ILD 的诊断效用和安全性的关键问题。MEDLINE（通过 PubMed）和 Cochrane 图书馆系统地搜索了相关文献，并辅以手动搜索。对参考文献进行筛选纳入，并使用经过审查的评估工具来评估纳入研究的质量、提取数据、并对支持每项建议或陈述的证据级别进行分级。分级推荐和未分级的基于共识的声明被起草并投票使用修改后的德尔菲技术来达成共识。结果 基于 4 个 PICO 问题的文献系统回顾和批判性分析得出 6 个陈述：2 个基于证据的分级推荐和 4 个未分级的基于共识的陈述。结论 TBC 用于诊断 ILD 的实用性和安全性的证据有限，但表明 TBC 比 SLB 更安全，并且通过多学科讨论获得的诊断贡献与 SLB 相当，尽管 SLB 的组织学诊断率似乎更高。 TBC 大约 80% VS SLB 95%）。