fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2024-9-3-120-129fcmedicine-907Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESК оценке состояния респираторных отделов легких с помощью трансбронхиальной игольной криобиопсии под контролем эндосонографии (аналитический обзор)Endobronchial ultrasound-guided transbronchial fine needle aspiration: synopsis and prospectshttps://orcid.org/0000-0002-1523-9669КобылянскийВ. И.KobylyanskyV. I.

Кобылянский Вячеслав Иванович, доктор медицинских наук, профессор образовательного центра

115682, г. Москва, Ореховый б-р, д. 28

 

Prof. Vyacheslav I. Kobylyansky, MD, DSc, Professor, Educational Centre, Research Institute of Pulmonology

28, Orekhovy Boulevard, Moscow, 115682

kobylyansky@mail.ruФГБУ «Научно-исследовательский институт пульмонологии Федерального медико-биологического агентства России»РоссияResearch Institute of Pulmonology, Federal Medical and Biological Agency of Russian FederationRussian Federation20242709202493120129Copyright © Кобылянский В.И., 20242024Кобылянский В.И.Kobylyansky V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/907

Несмотря на высокую информативность разных методов оценки состояния респираторных отделов легких, для уточнения патогенетических особенностей патологического процесса и верификации диагноза часто требуется получение биологического материала для разного рода исследований, обеспечивающих точность этой оценки. Материал получают путем биопсии легочной ткани из различных участков легких, наиболее пораженных патологическим процессом. Традиционными методами получения биоптата являются хирургическая биопсия, считающаяся золотым стандартом, но сопряженная со значительными осложнениями и летальностью, и чрезбронхиальная щипцовая биопсия, являющаяся менее инвазивным, но существенно менее информативным методом по качеству получаемого материала. За последние годы разработаны методы, также основанные на чрезбронхиальном заборе биоптатов легочной ткани, но позволяющие получать более качественный материал для исследований. Наиболее информативным из них представляется трансбронхиальная игольная криобиопсия под контролем эндосонографии (ТБИКЭ) и разные модификации данного метода, в том числе отечественные, которые оценены в данном обзоре. В результате оценена ТБИКЭ и разные способы ее использования, отражены их возможности, наличие существенной новизны, целесообразность и перспективы использования. В заключении отмечаются высокая информативность метода ТБИКЭ, значительно преобладающего над щипцовой биопсией, наличие положительных технических решений в одних способах его использования и отсутствие таковых в других, целесообразность и перспективы совершенствования ТБИКЭ, в том числе путем стандартизации данного диагностического метода.

Despite the high informativeness of minimally invasive methods for assessing respiratory system, lung tissue biopsy is often required to verify the diagnosis. Conventional methods include surgical biopsy, which considered as the gold standard but is associated with significant complications and mortality, and transbronchial biopsy, a less invasive but substantially less informative method. The most informative and novel approach is endobronchial ultrasoundguided transbronchial fine needle aspiration (EBUS-TBNA), which significantly surpasses forceps biopsy. Here I focus on EBUS-TBNA, highlighting its capabilities, the future prospects, expedient technical solutions in certain of its modification and the lack thereof in others, and approaches for the standardization.

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The authors declare that there are no conflicts of interest present.