B42-25 Diagnostic Value of EBUS-guided Transbronchial Mediastinal Cryobiopsy Versus Conventional Bronchoscopic Approaches for Stage I/II Sarcoidosis

Rationale The direct comparison between endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), combined with endobronchial biopsy (EBB) and/or transbronchial lung biopsy (TBLB), and endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-TBMC) in diagnosing sarcoidosis has not been conducted. To evaluate whether EBUS-TBMC have the same or better diagnostic sensitivity for sarcoidosis than EBUS-TBNA combined with standard bronchoscopic modalities (EBB and/or TBLB). Methods The records of patients with stage I/II sarcoidosis from four centers in China who underwent EBUS-TBMC or EBUS-TBNA combined with EBB and/or TBLB were retrospectively examined. Data on bronchoscopy examination records, pathological results of bronchoscopic biopsy modalities, and postprocedural complications were collected. The outcomes were diagnostic sensitivity and the incidence of postprocedural complications. Results A total of 438 patients were included in the study. Compared with EBUS-TBNA, EBUS-TBMC had greater diagnostic sensitivity for sarcoidosis (95.1% versus 84.1%, p < 0.001). The diagnostic sensitivity of EBUS-TBNA combined with EBB and/or TBLB was greater than that of EBUS-TBNA alone. No significant differences in diagnostic sensitivity were detected between EBUS-TBMC and EBUS-TBNA combined with EBB and/or TBLB or between EBUS-TBMC and EBUS-TBMC combined with EBB and/or TBLB. No major adverse complications related to the bronchoscopic procedure were observed. Conclusions EBUS-TBMC shows diagnostic sensitivity equivalent to EBUS-TBNA combined with EBB and/or TBLB, and superior to EBUS-TBNA alone for stage I/II sarcoidosis. The addition of EBB and/or TBLB to EBUS-TBMC did not improve the diagnostic sensitivity of EBUS-TBMC for sarcoidosis. EBUS-TBMC has the potential to obviate the need for EBB and TBLB. This abstract is funded by: Noncommunicable Chronic Diseases-National Science and Technology Major Project