Diagnostic Application of Bronchoalveolar Lavage Fluid Analysis in Cases of Idiopathic Pulmonary Fibrosis in which Diagnosis Cannot Be Confirmed by High-Resolution Computed Tomography.

IF 4.6 2区医学 Q1 RESPIRATORY SYSTEM Lung Pub Date : 2025-01-03 DOI:10.1007/s00408-024-00758-3

Boyi Chen, Zhefeng Leng, Jianhui Zhang, Xuefei Shi, Shunli Dong, Bin Wang

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Abstract

Purpose: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic lung disorder characterized by dry cough, fatigue, and exacerbated dyspnea. The prognosis of IPF is notably unfavorable, becoming extremely poor when the disease advances acutely. Effective therapeutic intervention is essential to mitigate disease progression; hence, early diagnosis and treatment are paramount. When high-resolution computed tomography (HRCT) reveals usual interstitial pneumonia (UIP), a diagnosis of IPF can be established. However, when HRCT fails to conclusively confirm IPF, the diagnostic pathway becomes intricate and necessitates a multidisciplinary approach involving clinicians, radiologists, and pathologists. Consequently, the objective of this study was to investigate new diagnostic approaches through bronchoalveolar lavage (BAL) analysis.

Methods: BAL is a commonly utilized diagnostic tool for interstitial lung diseases. We review the application of bronchoalveolar lavage (BALF) in idiopathic pulmonary fibrotic disease, emphasizing that the cellular and solute composition of the lower respiratory tract offers valuable insights.

Results: This review delineates the advancements in diagnosing IPF cases that remain indeterminate via HRCT, leveraging BALF analysis. In contrast to surgical lung biopsy, BAL is minimally invasive and offers potential diagnostic utility through the identification of specific BALF biomarkers.

Conclusion: Augment the clinical diagnostic armamentarium for IPF, particularly in scenarios where HRCT findings are inconclusive.

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目的：特发性肺纤维化（IPF）是一种慢性、进行性肺纤维化疾病，以干咳、乏力和加重的呼吸困难为特征。IPF 的预后明显不佳，当病情急性发展时，预后会变得极差。有效的治疗干预对缓解疾病进展至关重要；因此，早期诊断和治疗至关重要。当高分辨率计算机断层扫描（HRCT）发现寻常间质性肺炎（UIP）时，即可确诊为 IPF。然而，当 HRCT 无法最终确诊 IPF 时，诊断路径就变得错综复杂，需要临床医生、放射科医生和病理学家共同参与的多学科方法。因此，本研究旨在通过支气管肺泡灌洗液（BAL）分析研究新的诊断方法：方法：BAL 是间质性肺疾病的常用诊断工具。我们回顾了支气管肺泡灌洗液（BALF）在特发性肺纤维化疾病中的应用，强调下呼吸道的细胞和溶质组成提供了有价值的见解：本综述介绍了利用 BALF 分析诊断通过 HRCT 仍无法确定的 IPF 病例的进展。与外科肺活检相比，BAL 具有微创性，并可通过鉴定特定的 BALF 生物标记物提供潜在的诊断效用：增加 IPF 的临床诊断手段，尤其是在 HRCT 结果不确定的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lung 医学-呼吸系统

CiteScore

9.10

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.