Endobronchial ultrasound–guided transbronchial mediastinal cryobiopsy versus transbronchial needle aspiration for diagnosing sarcoidosis: A randomized controlled trial

作者：Mingming Deng, Fei Tang, Yifei Chen, Shuai Zhao, Run Tong, Zhen Yang, Changhao Zhong, Feng Wang, Quncheng Zhang, Ziwen Zheng, Nan Zhang, Guowu Zhou, Gang Hou · 发表于：Endoscopic Ultrasound · 年份：2025 · DOI：10.1097/eus.0000000000000147 · 被引用次数：6 · 研究领域：Sarcoidosis and Beryllium Toxicity Research、Lung Cancer Diagnosis and Treatment、Vascular Anomalies and Treatments

Abstract Background and Objectives Endobronchial ultrasound (EBUS)–guided transbronchial mediastinal cryobiopsy (TBMC) has potential superiority compared with EBUS-guided transbronchial needle aspiration (TBNA) in the diagnosis of patients with intrathoracic sarcoidosis. However, high-quality clinical evidence is lacking. The aim of this study was to compare the efficacy and safety of EBUS-TBMC and EBUS-TBNA in diagnosing patients with intrathoracic sarcoidosis. Methods A multicenter randomized controlled trial was conducted in patients with suspected stage I/II sarcoidosis. Following identification of the mediastinal lesion via EBUS, TBNA and TBMC were sequentially performed in a randomized order. The granuloma detection rate was the primary outcome. The final diagnosis was based on pathology results and clinical follow-up at 6 months after randomization. Results A total of 128 patients with suspected stage I/II sarcoidosis were recruited for this study. Among them, 116 patients were diagnosed with sarcoidosis at 6 months after randomization. The granuloma detection rate was 89.8% (95% confidence interval [CI], 83.3–94.5) for EBUS-TBMC and 78.1% (95% CI, 70.0–84.9) for EBUS-TBNA, and the difference was significant ( P < 0.001). The histological quality of the EBUS-TBMC samples was superior to that of the EBUS-TBNA samples ( P < 0.001). Only one case of pneumothorax was detected by chest radiography, which resolved spontaneously without the need for drainage or other in...