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Master Thesis

Comparaison de la cryobiopsie transbronchique et de la biopsie pulmonaire chirurgicale en réunion de discussion multidisciplinaire dans les pneumopathies interstitielles diffuses

Abstract : Recently, a poor concordance between transbronchial cryobiopsy (TBLC) and surgical lung biopsy (SLB), the current gold standard, has been reported in the diagnostic approach of diffuse Interstitial Lung Disease (ILD). However, in this study, pathological reports were analyzed by a pathologist blind from clinical and morphological data. The objective of this study was to evaluate the diagnostic and therapeutic decision concordances between TBLC and SLB, by reintegrating their results into a MultiDisciplinary Discussion (MDD). 16 patients suffering from ILD were presented in MDD in two centers specialized in managing ILD. These patients underwent at the same time a TBLC and a SLB. One of the two pathological reports (TBLC or SLB), assigned randomly, was presented to one of the MDD, the other MDD benefiting from the histology obtained by the other method. A single diagnosis was proposed by each MDD (MDA2 Diagnosis) with a therapeutic decision (MDA2 treatment). Cohen Kappa concordance coefficient was evaluated between MDA2 diagnosis and treatment between TBLC and SLB, as well as between the MDA2 diagnosis and the diagnosis retained after one year of follow-up. Kappa coefficients for MDA2 diagnosis and treatment were good, respectively 0.74 (0.49-1), and 0.64 (0.36-0.92), depending on whether the histology was obtained by TBLC or SLB. When one year of follow-up was the gold standard, Kappa for SLB tended to be higher than Kappa for TBLC (0.91 (0.75-1) vs 0.67 (0.389-0.95)). The reintegration of pathological results in MDD lead to a better concordance between TBLC and SLB.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02939348
Contributor : Scd Université de Montpellier <>
Submitted on : Tuesday, September 15, 2020 - 3:14:48 PM
Last modification on : Tuesday, October 27, 2020 - 3:27:23 AM

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  • HAL Id : dumas-02939348, version 1

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Camille Travert. Comparaison de la cryobiopsie transbronchique et de la biopsie pulmonaire chirurgicale en réunion de discussion multidisciplinaire dans les pneumopathies interstitielles diffuses. Human health and pathology. 2019. ⟨dumas-02939348⟩

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