形状传感机器人辅助支气管镜检查 (ssRAB) 已成为一种很有前景的工具，可提高肺结节 (PPN) 采样的性能。先前的研究表明，对于不同的病灶大小，1.1 毫米冷冻探针与细针抽吸 (FNA) 一样有效。我们的目标是将 1.1 mm 冷冻探针与 FNA 的性能进行比较，以使用 ssRAB 对 PPN < 20 mm 进行采样。我们于 2022 年 11 月至 2024 年 2 月对接受 ssRAB 冷冻活检以评估 PPN 的患者进行了一项回顾性队列研究。我们比较了同一 PPN 的冷冻活检和细针穿刺活检 (FNA) 对恶性肿瘤的诊断率和敏感性。使用麦克尼马尔检验和比例比较进行描述性统计分析。多变量逻辑回归评估了 PPN 特征对每种工具产量的影响。我们纳入了 256 名患者，总共进行了 284 次手术，并采样了 324 个结节。结节最大和最小尺寸中位数分别为 1.6 cm (IQR 1.17-2.4) 和 1.17 cm (IQR 0.86-1.7)。 ssRAB 的总体诊断率为 93.8%，恶性肿瘤的敏感性为 97.5%。冷冻活检的诊断率为 92%，敏感性为 96%，FNA 分别为 70.4% 和 79.29%（P < 0.001）。与 FNA 相比，冷冻活检在所有分析类别中的性能均显着更高 (P < 0.05)，但混合型病变的敏感性除外 (P = 0.11)。 PPN < 10 mm 和 ≥ 10 mm - <15 mm 采用 FNA 取样，与 ≥ 20 mm 组相比，获得诊断的几率较低（OR = 0.305 IC95%：0.142-0.65，p < 0.001；OR = 0.497 IC95% ：0.263-0.939，p = 0.031，分别）。 5.98% (N = 17) 的病例出现并发症。与 FNA 相比，冷冻活检在统计上显示出更高的恶性肿瘤诊断率和敏感性。值得注意的是，FNA 显示 PPN < 15 mm 的诊断几率降低。 ssRAB 结合冷冻活检可以提高 PPN 诊断率，从而实现早期肺癌诊断并提高长期生存率。版权所有 © 2024 Elsevier B.V. 保留所有权利。

Shape-sensing Robotic-assisted Bronchoscopy (ssRAB) has emerged as a promising tool for improved performance when sampling pulmonary nodules (PPN). Previous studies suggest that the 1.1 mm cryoprobe is as effective compared to fine needle aspiration (FNA), for different lesions sizes. We aim to compare the 1.1 mm cryoprobe performance to FNA for sampling PPN < 20 mm with ssRAB.We conducted a retrospective cohort study from November 2022 to February 2024 of patients who underwent ssRAB with cryobiopsy for evaluation of PPN. We compared the diagnostic yield and sensitivity for malignancy of cryobiopsy and FNA for the same PPN. Descriptive statistical analysis was conducted using the McNemar's Test and Comparison of proportion. Multivariate logistic regression assessed the impact of PPN characteristics on the yield of each tool.We included 256 patients, with a combined 284 procedures, and 324 nodules sampled. The median maximum and minimum nodule size was 1.6 cm (IQR 1.17-2.4) and 1.17 cm (IQR 0.86-1.7) respectively. The overall ssRAB diagnostic yield was 93.8 % and sensitivity for malignancy was 97.5 %. Cryobiopsy had a diagnostic yield of 92 % and sensitivity of 96 %, FNA had a 70.4 % and 79.29 % respectively (P < 0.001). Cryobiopsy had a significantly higher performance compared to FNA across the analyzed categories (P < 0.05), except for the sensitivity of mixed-type lesions (P = 0.11). PPN < 10 mm and ≥ 10 mm - <15 mm sampled with FNA, had lower odds of achieving a diagnosis compared to the ≥ 20 mm group (OR = 0.305 IC95%: 0.142-0.65, p < 0.001; OR = 0.497 IC95%: 0.263-0.939, p = 0.031, respectively). Complications occurred in 5.98 % (N = 17) of cases.Cryobiopsy demonstrates a statistically higher diagnostic yield and sensitivity for malignancy compared to FNA. Remarkably, FNA showed reduced diagnostic odds in PPN < 15 mm. ssRAB with cryobiopsy could enhance PPN diagnostic yield, leading to earlier lung cancer diagnosis and improve long-term survival rates.Copyright © 2024 Elsevier B.V. All rights reserved.