Department of Internal Medicine, Florida Hospital, Orlando, Florida, USA.
Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
Gastrointest Endosc. 2019 Feb;89(2):340-344. doi: 10.1016/j.gie.2018.08.050. Epub 2018 Sep 5.
Rapid onsite evaluation of touch imprint cytology (ROSE-TIC) is a simple and rapid method used for the diagnosis of benign and malignant lesions. We evaluated the diagnostic accuracy of ROSE-TIC for advanced intestinal luminal and indeterminate pancreatobiliary lesions during endoscopy.
This is a retrospective descriptive study of patients who underwent endoscopy or ERCP between January 1, 2014 and December 31, 2016. It included patients who were referred for the treatment of intestinal luminal lesions or evaluation of indeterminate pancreatobiliary lesions. The slides were prepared by gently touching the specimen onto a glass slide and were examined under the microscope. The main outcome measure was to determine the diagnostic accuracy of ROSE-TIC by comparing the onsite cytology findings with the corresponding off-site histologic diagnosis.
All 222 patients (106 pancreatobiliary and 116 GI lesions) had a prior benign diagnosis of intestinal luminal lesions or indeterminate diagnosis of pancreatobiliary lesions. The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ROSE-TIC were 97%, 85%, 83%, 97.2%, and 90%, respectively. The accuracy varied with the site of the biopsy sample. The accuracy was lowest for upper GI tract, where it was 85.2% but was 95% for lower GI tract lesions.
By establishing a rapid onsite diagnosis, ROSE-TIC expedites decision-making on patient management. Prospective studies are needed to confirm these preliminary findings.
即时现场细胞学评估(ROSE-TIC)是一种用于诊断良恶性病变的简单、快速的方法。我们评估了 ROSE-TIC 在内镜下对进展期肠腔和不确定的胰胆管病变的诊断准确性。
这是一项回顾性描述性研究,纳入了 2014 年 1 月 1 日至 2016 年 12 月 31 日期间接受内镜或 ERCP 检查的患者。这些患者被转介来治疗肠腔病变或评估不确定的胰胆管病变。通过轻轻将标本触压到载玻片上来制备载玻片,并在显微镜下进行检查。主要观察指标是通过比较现场细胞学发现与相应的非现场组织学诊断来确定 ROSE-TIC 的诊断准确性。
所有 222 例患者(106 例胰胆管病变和 116 例 GI 病变)均有肠腔良性病变的既往诊断或胰胆管病变的不确定诊断。ROSE-TIC 的总体敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 97%、85%、83%、97.2%和 90%。准确性因活检样本部位而异。上消化道的准确性最低,为 85.2%,而下消化道病变的准确性为 95%。
通过建立快速的现场诊断,ROSE-TIC 可加快患者管理的决策过程。需要前瞻性研究来证实这些初步发现。