Department of Pathology, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Diagn Cytopathol. 2021 Jul;49(7):832-837. doi: 10.1002/dc.24749. Epub 2021 Apr 12.
The increase in immunohistochemical and molecular predictive tests in lung cancer requires new strategies for managing small samples taken during bronchoscopic procedures. The value of Rapid On Site Evaluation (ROSE) during conventional bronchoscopic procedures on endobronchial neoplasms in optimizing small biopsies and cytologlogical tissue specimens for diagnostic testing, and ancillary studies was evaluated.
ROSE on touch imprint cytology (TIC) and brushing was performed on 690 consecutive cases of patients undergoing biopsies, using fiber optic bronchoscopy. Immunohistochemical assay for PD-L1, ALK, and ROS1 and molecular testing, via next generation technique for EGFR, KRAS, and BRAF, were performed.
The concordance between ROSE and final diagnoses was almost perfect for brushing (sensitivity: 0.84; specificity: 0.96), and less so for touch preparations (sensitivity: 0.77; specificity: 0.89). Immunohistochemical assay for PD-L1 was evaluated on 256 bioptic cases with only six unsuitable samples. Material available for immunohistochemistry for ALK was sufficient in 151 biopsies with no inadequate cases. ROS1 was evaluated in 132 biopsies, with only two unsuitable samples. Molecular analysis was performed on 128 biopsies, 29 TIC, and 17 brushing. Out of these, only ten were considered to be unsuitable.
ROSE is an effective procedure for monitoring the quality and quantity of material taken during conventional bronchoscopic procedures for evaluating the suitability of small samples that must undergo immunohistochemical and molecular assay.
肺癌免疫组化和分子预测检测的增加，需要在支气管镜检查过程中对小样本采取新的管理策略。本研究评估了快速现场评估（ROSE）在支气管内肿瘤常规支气管镜检查中对优化小活检和细胞学组织标本进行诊断检测和辅助研究的价值。
对 690 例接受活检的患者进行纤维支气管镜检查，采用触诊印片细胞学（TIC）和刷检进行 ROSE，对 PD-L1、ALK 和 ROS1 进行免疫组化检测，采用下一代技术进行 EGFR、KRAS 和 BRAF 基因的分子检测。
刷检的 ROSE 与最终诊断的一致性几乎为完美（敏感性：0.84；特异性：0.96），而触诊制片的一致性稍差（敏感性：0.77；特异性：0.89）。对 256 例活检标本进行了 PD-L1 免疫组化检测，仅有 6 例标本不合适。151 例活检标本有足够的材料进行 ALK 免疫组化检测，无不合适标本。132 例活检标本评估了 ROS1，仅有 2 例标本不合适。对 128 例活检标本、29 例 TIC 和 17 例刷检标本进行了分子分析。其中只有 10 例被认为不合适。
ROSE 是一种有效的方法，可监测常规支气管镜检查中小样本进行免疫组化和分子检测的质量和数量，以评估其适用性。
