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快速现场评估经支气管超声引导针吸活检术对肺癌的诊断价值:来自肺病理学协会成员的观点。

Rapid On-Site Evaluation of Endobronchial Ultrasound-Guided Transbronchial Needle Aspirations for the Diagnosis of Lung Cancer: A Perspective From Members of the Pulmonary Pathology Society.

出版信息

Arch Pathol Lab Med. 2018 Feb;142(2):253-262. doi: 10.5858/arpa.2017-0114-SA. Epub 2017 Jun 22.

DOI:10.5858/arpa.2017-0114-SA
PMID:28639854
Abstract

CONTEXT

  • Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool in the field of diagnostic respiratory cytology. Rapid on-site evaluation (ROSE) of EBUS-TBNA not only has the potential to improve diagnostic yield of the procedure but also to triage samples for predictive molecular testing to guide personalized treatments for lung cancer.

OBJECTIVE

  • To provide an overview of the current status of the literature regarding ROSE of EBUS-TBNA in the diagnosis of lung cancer.

DATA SOURCES

  • An electronic literature search in PubMed and Google databases was performed using the following key words: cytology, lung cancer, on-site evaluation, rapid on-site evaluation, and ROSE EBUS-TBNA. Only articles published in English were included in this review.

CONCLUSIONS

  • Rapid on-site evaluation can ensure that the targeted lesion is being sampled and can enable appropriate specimen triage. If available, it should be used with EBUS-TBNA in the diagnosis of lung cancer because it can minimize repeat procedures for additional desired testing (ie, molecular studies). Some studies have shown that ROSE does not adversely affect the number of aspirations, total procedure time of EBUS-TBNA, or the rate of postprocedure complications; it is also helpful in providing a preliminary diagnosis that can reduce the number of additional invasive procedures, such as mediastinoscopy. As EBUS technology continues to evolve, our knowledge of the role of ROSE in EBUS-TBNA for the diagnosis of lung cancer will also continue to grow and evolve.
摘要

背景

  • 支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)已成为诊断性呼吸细胞学领域非常有用的工具。EBUS-TBNA 的现场快速评估(ROSE)不仅有可能提高该程序的诊断效果,还有可能对样本进行分类,以便进行预测性分子检测,从而为肺癌的个体化治疗提供指导。

目的

  • 对 EBUS-TBNA 在肺癌诊断中进行 ROSE 的现有文献进行综述。

资料来源

  • 在 PubMed 和 Google 数据库中进行电子文献检索,使用以下关键词:细胞学、肺癌、现场评估、快速现场评估和 ROSE EBUS-TBNA。本综述仅纳入了发表在英文期刊上的文章。

结论

  • 现场快速评估可以确保靶向病变得到取样,并能够对标本进行适当的分类。如果可行,它应该与 EBUS-TBNA 联合用于肺癌诊断,因为它可以最大限度地减少重复进行额外所需检测(即分子研究)的次数。一些研究表明,ROSE 不会对抽吸次数、EBUS-TBNA 的总操作时间或术后并发症的发生率产生不利影响;它还有助于提供初步诊断,从而减少其他侵袭性操作(如纵隔镜检查)的次数。随着 EBUS 技术的不断发展,我们对 ROSE 在 EBUS-TBNA 诊断肺癌中的作用的认识也将不断发展和演变。

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