Annual progress in transbronchial diagnosis and treatment of pulmonary malignant tumors [2025]: a narrative review.

BACKGROUND AND

OBJECTIVE

The rapid advancement of transbronchial endoscopic interventional techniques is profoundly transforming the diagnostic and therapeutic landscape of pulmonary malignant tumors. This article reviews high-quality, high-impact clinical studies on transbronchial diagnosis and treatment of pulmonary malignant tumors published in 2025, covering: precise diagnosis of peripheral pulmonary lesions (PPLs), lymph node biopsy strategies, combined utilization of multiple biopsy tools, artificial intelligence (AI)-assisted diagnostic system and rapid on-site evaluation (ROSE) for biopsy strategies development, ablation for peripheral pulmonary malignant tumors and central airway interventions, with a focus on their clinical application value.

METHODS

A literature search was conducted in PubMed using medical subject headings (MeSH) terms including "Bronchoscopy", "Lung Neoplasms", "Solitary Pulmonary Nodule", "Multiple Pulmonary Nodules", "Airway Obstruction", "Bronchial Neoplasms", and related free words. The search was limited to English-language articles published in 2025, including original studies, meta-analyses, and case reports.

KEY CONTENT AND FINDINGS: We identified 59 papers published in 2025 on transbronchial diagnosis and treatment of pulmonary malignant tumors, and selected 36 high-value publications for this review based on clinical significance and literature quality. Guided bronchoscopy techniques, particularly robotic-assisted bronchoscopy (RAB), demonstrated superior diagnostic performance for PPLs. Transbronchial lymph node biopsy achieved a higher diagnostic yield through cryobiopsy. The combined utilization of multiple biopsy tools improved diagnostic yield for PPLs. AI-assisted diagnostic system and ROSE further enhanced the ability to differentiate benign from malignant lesions, thereby optimizing biopsy strategies. Precision and efficient ablation systems provided significant survival benefits for patients with peripheral pulmonary malignant tumors. The development of novel ablation techniques offered new non-surgical interventional options for patients with central airway malignant tumors.

CONCLUSIONS

Significant advancements in transbronchial diagnosis and treatment of pulmonary malignant tumors were achieved in 2025. Represented by RAB, guided bronchoscopy techniques with enhanced flexibility and lesion accessibility; the multi-tool biopsy strategy with AI assistance and novel ablation systems with improved precision and efficacy are expected to influence future clinical practice and research directions in pulmonary malignant tumor management.