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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...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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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 |
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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 |
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