经支气管肺冷冻活检在CTD-ILD诊断中的应用价值:基于2025年ERS/ATS IP新分类更新的回顾性研究OA

Objective To investigate the diagnostic value of transbronchial lung cryobiopsy(TBLC)in connec-tive tissue disease-associated interstitial lung disease(CTD-ILD)and analyze its pathological features based on the 2025 European Respiratory Society(ERS)/American Thoracic Society(ATS)interstitial pneumonia classification up-date.Methods A retrospective analysis included 195 patients with diffuse lung disease who underwent TBLC,of whom 29 were diagnosed with CTD-ILD via a comprehensive clinico-radiologic-pathologic(CRP)assessment.Data on patient demographics,clinical features,and TBLC pathological findings were collected.Results The 29 CTD-ILD patients accounted for 14.87%(29/195)of the TBLC cohort.The main clinical manifestations were cough(62.07%)and dyspnea(51.72%).Pathological patterns were heterogeneous and often mixed.Organizing pneumonia(OP,28.21%)and nonspecific interstitial pneumonia(NSIP,25.64%)were the most common patterns,with OP fre-quently coexisting with usual interstitial pneumonia(UIP)or NSIP.The effective tissue ratio was significantly higher in the definitive pathological diagnosis group compared to the suspicious diagnosis group(91.67%vs 55.56%,P<0.001).Among CTD subtypes,Sjögren's syndrome(SS)and polymyositis/dermatomyositis(PM/DM)were predomi-nant,and their pathological manifestations aligned with the"overlap pattern"concept of the 2025 ERS/ATS classifica-tion.Conclusion TBLC can yield high-quality lung tissue and holds significant diagnostic value for CTD-ILD.The observed pathological features are consistent with the 2025 ERS/ATS classification update,supporting the role of TBLC combined with multidisciplinary discussion in CTD-ILD diagnosis.