Cargando…

Transbronchial biopsy is useful in predicting UIP pattern

BACKGROUND: Usual interstitial pneumonia (UIP), is a necessary feature pathologically or radiologically for the diagnosis of idiopathic pulmonary fibrosis (IPF). The predictive value of transbronchial biopsy (TBB) in identifying UIP is currently unknown. The objective of this study is to assess the...

Descripción completa

Detalles Bibliográficos
Autores principales: Tomassetti, Sara, Cavazza, Alberto, Colby, Thomas V, Ryu, Jay H, Nanni, Oriana, Scarpi, E, Tantalocco, Paola, Buccioli, Matteo, Dubini, Alessandra, Piciucchi, Sara, Ravaglia, Claudia, Gurioli, Christian, Casoni, Gian Luca, Gurioli, Carlo, Romagnoli, Micaela, Poletti, Venerino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499172/
https://www.ncbi.nlm.nih.gov/pubmed/23107232
http://dx.doi.org/10.1186/1465-9921-13-96
_version_ 1782249910032138240
author Tomassetti, Sara
Cavazza, Alberto
Colby, Thomas V
Ryu, Jay H
Nanni, Oriana
Scarpi, E
Tantalocco, Paola
Buccioli, Matteo
Dubini, Alessandra
Piciucchi, Sara
Ravaglia, Claudia
Gurioli, Christian
Casoni, Gian Luca
Gurioli, Carlo
Romagnoli, Micaela
Poletti, Venerino
author_facet Tomassetti, Sara
Cavazza, Alberto
Colby, Thomas V
Ryu, Jay H
Nanni, Oriana
Scarpi, E
Tantalocco, Paola
Buccioli, Matteo
Dubini, Alessandra
Piciucchi, Sara
Ravaglia, Claudia
Gurioli, Christian
Casoni, Gian Luca
Gurioli, Carlo
Romagnoli, Micaela
Poletti, Venerino
author_sort Tomassetti, Sara
collection PubMed
description BACKGROUND: Usual interstitial pneumonia (UIP), is a necessary feature pathologically or radiologically for the diagnosis of idiopathic pulmonary fibrosis (IPF). The predictive value of transbronchial biopsy (TBB) in identifying UIP is currently unknown. The objective of this study is to assess the accuracy with which histopathologic criteria of usual interstitial pneumonia (UIP) can be identified in transbronchial biopsy (TBB) and to assess the usefulness of TBBx in predicting a the diagnosis of UIP pattern. We conducted a retrospective blinded and controlled analysis of TBB specimens from 40 established cases of UIP and 24 non-UIP interstitial lung diseases. RESULTS: Adequate TBB specimens were available in 34 UIP cases (85% of all UIP cases). TBB contained histopathologic criteria to suggest a UIP pattern (ie. at least one of three pathologic features of UIP present; patchy interstitial fibrosis, fibroblast foci, honeycomb changes) in 12 cases (30% of all UIP cases). Sensitivity, specificity, positive and negative predictive values for the two pathologists were 30% (12/40), 100% (24/24), 100% (12/12), 46% (24/52) and 30% (12/40), 92% (22/24), 86% (12/14), 55% (22/40) respectively. Kappa coefficient of agreement between pathologists was good (0.61, 95% CI 0.31-0.91). The likelihood of identifying UIP on TBB increased with the number and size of the TBB specimens. CONCLUSION: Although sensitivity is low our data suggest that even modest amount of patchy interstitial fibrosis, fibroblast foci, honeycomb changes detected on TBB can be highly predictive of a UIP pattern. Conversely, the absence of UIP histopathologic criteria on TBB does not rule out UIP.
format Online
Article
Text
id pubmed-3499172
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-34991722012-11-16 Transbronchial biopsy is useful in predicting UIP pattern Tomassetti, Sara Cavazza, Alberto Colby, Thomas V Ryu, Jay H Nanni, Oriana Scarpi, E Tantalocco, Paola Buccioli, Matteo Dubini, Alessandra Piciucchi, Sara Ravaglia, Claudia Gurioli, Christian Casoni, Gian Luca Gurioli, Carlo Romagnoli, Micaela Poletti, Venerino Respir Res Research BACKGROUND: Usual interstitial pneumonia (UIP), is a necessary feature pathologically or radiologically for the diagnosis of idiopathic pulmonary fibrosis (IPF). The predictive value of transbronchial biopsy (TBB) in identifying UIP is currently unknown. The objective of this study is to assess the accuracy with which histopathologic criteria of usual interstitial pneumonia (UIP) can be identified in transbronchial biopsy (TBB) and to assess the usefulness of TBBx in predicting a the diagnosis of UIP pattern. We conducted a retrospective blinded and controlled analysis of TBB specimens from 40 established cases of UIP and 24 non-UIP interstitial lung diseases. RESULTS: Adequate TBB specimens were available in 34 UIP cases (85% of all UIP cases). TBB contained histopathologic criteria to suggest a UIP pattern (ie. at least one of three pathologic features of UIP present; patchy interstitial fibrosis, fibroblast foci, honeycomb changes) in 12 cases (30% of all UIP cases). Sensitivity, specificity, positive and negative predictive values for the two pathologists were 30% (12/40), 100% (24/24), 100% (12/12), 46% (24/52) and 30% (12/40), 92% (22/24), 86% (12/14), 55% (22/40) respectively. Kappa coefficient of agreement between pathologists was good (0.61, 95% CI 0.31-0.91). The likelihood of identifying UIP on TBB increased with the number and size of the TBB specimens. CONCLUSION: Although sensitivity is low our data suggest that even modest amount of patchy interstitial fibrosis, fibroblast foci, honeycomb changes detected on TBB can be highly predictive of a UIP pattern. Conversely, the absence of UIP histopathologic criteria on TBB does not rule out UIP. BioMed Central 2012 2012-10-29 /pmc/articles/PMC3499172/ /pubmed/23107232 http://dx.doi.org/10.1186/1465-9921-13-96 Text en Copyright ©2012 Tomassetti et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Tomassetti, Sara
Cavazza, Alberto
Colby, Thomas V
Ryu, Jay H
Nanni, Oriana
Scarpi, E
Tantalocco, Paola
Buccioli, Matteo
Dubini, Alessandra
Piciucchi, Sara
Ravaglia, Claudia
Gurioli, Christian
Casoni, Gian Luca
Gurioli, Carlo
Romagnoli, Micaela
Poletti, Venerino
Transbronchial biopsy is useful in predicting UIP pattern
title Transbronchial biopsy is useful in predicting UIP pattern
title_full Transbronchial biopsy is useful in predicting UIP pattern
title_fullStr Transbronchial biopsy is useful in predicting UIP pattern
title_full_unstemmed Transbronchial biopsy is useful in predicting UIP pattern
title_short Transbronchial biopsy is useful in predicting UIP pattern
title_sort transbronchial biopsy is useful in predicting uip pattern
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499172/
https://www.ncbi.nlm.nih.gov/pubmed/23107232
http://dx.doi.org/10.1186/1465-9921-13-96
work_keys_str_mv AT tomassettisara transbronchialbiopsyisusefulinpredictinguippattern
AT cavazzaalberto transbronchialbiopsyisusefulinpredictinguippattern
AT colbythomasv transbronchialbiopsyisusefulinpredictinguippattern
AT ryujayh transbronchialbiopsyisusefulinpredictinguippattern
AT nannioriana transbronchialbiopsyisusefulinpredictinguippattern
AT scarpie transbronchialbiopsyisusefulinpredictinguippattern
AT tantaloccopaola transbronchialbiopsyisusefulinpredictinguippattern
AT bucciolimatteo transbronchialbiopsyisusefulinpredictinguippattern
AT dubinialessandra transbronchialbiopsyisusefulinpredictinguippattern
AT piciucchisara transbronchialbiopsyisusefulinpredictinguippattern
AT ravagliaclaudia transbronchialbiopsyisusefulinpredictinguippattern
AT guriolichristian transbronchialbiopsyisusefulinpredictinguippattern
AT casonigianluca transbronchialbiopsyisusefulinpredictinguippattern
AT guriolicarlo transbronchialbiopsyisusefulinpredictinguippattern
AT romagnolimicaela transbronchialbiopsyisusefulinpredictinguippattern
AT polettivenerino transbronchialbiopsyisusefulinpredictinguippattern