%0 Journal Article %A Ute Oltmanns %A Doris Rassl %A Mark Slade %T Quality matters in lung cancer diagnosis – Comparison of endobronchial cryobiopsy with conventional forceps biopsy %D 2011 %J European Respiratory Journal %P p1967 %V 38 %N Suppl 55 %X Introduction: Endoscopic forceps biopsies are often small and inadequate for detailed analysis whereas biopsies obtained with cryoprobes may provide tissue samples that are larger and better preserved. We compared the quality and complication rate of endoscopic forceps- and cryobiopsies.Methods: Prospectively collected data of patients who underwent cryobiopsy (CB, n=14) were compared with randomly selected patients who had conventional forceps biopsies (FB) during the same time period (n=13). All patients were considered prospectively to have definite endobronchial tumour. Sample size and quality was assessed. Complication rate and final diagnosis were also recorded.Results: Maximum sample diameter was significantly larger in the CB group (median 1.6cm, range 0.7-3.0cm) compared to the FB group (median 0.5cm, range 0.3-1.3cm, p<0.001). All biopsy samples were diagnostic of malignancy apart from 1 CB sample showing necrosis only. Semiquantitative analysis showed a smaller proportional tumor area within the biopsy when forceps were used (median 50%, range 0-90%) compared to the cryoprobe technique (median 90%, range 50-100%, p<0.001). 6 of 13 FBs had artifact changes affecting up to 90% of the biopsy whereas only 1 CB had minor artifact changes of 5%. 1 FB patient had mild bleeding. Mild and moderate bleeding were seen in 2 CB patients, respectively.Conclusions: Cryobiopsy appears to provide larger and higher-quality tumour specimens than conventional forceps biopsy. These differences may become important in an era of targeted therapies for individual patients, when multiple testing of biopsies is required. We believe the technique of cryobiopsy merits further evaluation. %U