Cryo-Biopsy versus 19G needle versus 22G needle with EBUS-TBNA endoscopy

Rena Oikonomidou¹, Dimitris Petridis³, Christoforos Kosmidis¹, Konstantinos Sapalidis¹, Wolfgang Hohenforst-Schmidt⁴, Vagelis Christakidis⁵, Savas Petanidis⁶, Dimitris Mathaios⁷, Eleni Isidora Perdikouri⁸, Sofia Baka⁹, Christos Tolis¹⁰, Anastasios Vagionas¹¹, Bojan Zaric¹², Aris Ioannidis¹³, Marios Anemoulis¹⁴, Konstantinos Porpodis¹⁵, Vasileios Papadopoulos¹⁶, Paul Zarogoulidis^17✉

1. Health Center of Evosmos, Thessaloniki, Greece.
2. 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.
3. Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece.
4. Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany.
5. Oncology Department, General Hospital of Serres, Serres, Greece.
6. Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
7. Oncology Department, General Hospital of Rhodes, Rhodes, Greece.
8. Oncology Department, General Hospital of Volos, Greece.
9. Oncology Department, “Interbalkan” European Medical Center, Thessaloniki, Greece.
10. Oncoderm, Private Oncology Clinic, Ioannina, Greece.
11. Oncology Department, General Hospital of Kavala, Kavala, Greece.
12. Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia.
13. Surgery Department, Genesis Private Hospital, Thessaloniki, Greece.
14. General Surgery Department, General Clinic Euromedica, Thessaloniki, Greece.
15. Pulmonary Department, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
16. Oncology Department, University General Hospital of Larissa, University of Thessali, Larissa, Greece.
17. Pulmonary-Oncology Department, “General Clinic” Private Clinic, Thessaloniki, Greece.

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Citation:
Oikonomidou R, Petridis D, Kosmidis C, Sapalidis K, Hohenforst-Schmidt W, Christakidis V, Petanidis S, Mathaios D, Perdikouri EI, Baka S, Tolis C, Vagionas A, Zaric B, Ioannidis A, Anemoulis M, Porpodis K, Papadopoulos V, Zarogoulidis P. Cryo-Biopsy versus 19G needle versus 22G needle with EBUS-TBNA endoscopy. J Cancer 2022; 13(10):3084-3090. doi:10.7150/jca.75589. Available from https://www.jcancer.org/v13p3084.htm

Abstract

Introduction: We have been using cryo-biopsy for endobronchial lesions for lung cancer diagnosis and debulking. Cryo-biopsy is also known to be an excellent tool for diagnosis of lung interstitial disease. Recently cryo-biopsy with the 1.1mm probe was used for lymphnode biopsy.

Patients and Methods: 311 patients participated with lymphadenopathy and at least one lung lesion. The following tools were used for diagnosis; 22G Mediglobe Sonotip, 22G Medigolbe, 21G Olympus, 19G Olympus and 1.1mm cryo probe ERBE CRYO 2 system (3 seconds froze). A PENTAX Convex-probe EBUS was used for biopsy guidance.

Results: Cell-blocks slices had a higher number in the 19G needle group (19G> Cryo Probe>22G Mediglobe Sonotip >21G Olympus >22G Mediglobe).

Conclusion: Cryo biopsy of the lymphnodes is safe with the 1.1mm cryo probe. Further studies are needed in order to evaluate new probes and the technique specifications.

Keywords: radial-ebus, Linear-EBUS, 22G needle, 21G needle, 19G needle, cryo-biopsy, bronchoscopy, lung cancer, cancer