间质性肺疾病冷冻肺活检标本病理诊断中国专家共识  

Chinese expert consensus on the pathological diagnosis of interstitial lung disease with transbronchial lung cryobiopsy specimens

作　　者：中国医师协会呼吸医师分会呼吸病理工作组 中华医学会病理学分会胸部疾病学组 冯瑞娥[2] 朱翔 杨子萱[5] 孟凡青 冯安宁[6] 张声[7] 黄慧[8] Respiratory Pathology Working Group of Respiratory Physicians Branch of Chinese Medical Doctor Association;Thoracic Disease Group of Pathology Branch of Chinese Medical Association;Feng Ruie(不详;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]不详 [2]中国医学科学院北京协和医学院北京协和医院病理科,北京100730 [3]北京大学医学部 [4]北京大学第三医院 [5]华中科技大学同济医学院附属武汉中心医院 [6]南京大学医学院附属南京鼓楼医院 [7]福建医科大学附属第一医院 [8]中国医学科学院北京协和医学院北京协和医院

出　　处：《中华结核和呼吸杂志》2024年第8期704-715,共12页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：中央高水平医院临床科研业务费(2022-PUMCH-C-069)。

摘　　要：经支气管冷冻肺活检(TBLC)已用于间质性肺疾病(ILD)的病理诊断,TBLC较外科肺活检标本小,病理诊断难度增大,业内缺乏关于TBLC病理诊断ILD的指导性共识/指南,为更好指导病理医师做好TBLC标本ILD的病理诊断,中国医师协会呼吸医师分会呼吸病理工作组、中华医学会病理学分会胸部疾病学组共同组织专家讨论及制定本共识。共识制定小组在文献复习的基础上结合临床实践,收集临床问题,经多次会议讨论及专家投票(Delphi法)形成本共识。共识总结了TBLC标本送检、评价、常见人为假象,提出TBLC标本的诊断原则、诊断流程、各主要病理改变对应的ILD类型以及主要鉴别诊断,并形成14条专家推荐意见,供临床诊断及多学科讨论参考。Transbronchial lung cryobiopsy(TBLC)is an applicable technique that can provide a histologic diagnosis of interstitial lung disease(ILD).The general sample size of TBLC is much smaller than that of surgical lung biopsy(SLB),which raises more concerns about the procedure's diagnostic accuracy.A guiding consensus and guidelines on the pathological procedure of ILD with TBLC are required to better guide pathologists in diagnostic practice.The Respiratory Pathology Working Group of the Respiratory Physicians Branch of the Chinese Medical Doctor Association and the Thoracic Diseases Group of the Pathological Branch of the Chinese Medical Association,jointly organized by experts,have worked together to discuss and formulated the consensus.The consensus is based on literature review,clinical practice,collection of clinical issues,and discussion during a series of meetings.Experts approved the final proposed consensus with more than 70%of votes in favor(Delphi).The consensus summarized the delivery requirements,quality evaluation and artificial phenomena of TBLC specimens.It also proposed the diagnostic principles and procedures,types of ILD corresponding to major pathological changes,and major corresponding differential diagnoses of TBLC specimens.Finally,the consensus formed 14 recommendations for clinical diagnosis and multidisciplinary discussion.The recommendations are addressed as follows.

关 键 词：间质性肺疾病 中国医师协会 病理医师 DELPHI法 病理诊断 肺活检 胸部疾病 诊断原则 

分 类 号：R563[医药卫生—呼吸系统]