Department of Pathology, Dr. Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India.
Department of Respiratory Medicine, Dr. Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India.
Cytopathology. 2021 Jul;32(4):428-435. doi: 10.1111/cyt.12975. Epub 2021 Apr 13.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool for precise diagnosis of thoracic lesions. However, the procedure sometimes has a poor yield. Rapid on-site evaluation (ROSE) in EBUS-TBNA has been shown to be helpful to improve its diagnostic yield and minimise the need for repeat procedures. Most of the studies that have evaluated the utility of ROSE have focused on malignant lesions; however, it is important to understand its utility in benign lesions, particularly in a country with a high tuberculosis burden.
This study was undertaken to evaluate the utility of ROSE in EBUS-TBNA for the diagnosis of patients presenting with mediastinal lymphadenopathy and/or thoracic mass for benign and malignant pathologies.
This was a prospective study including 47 patients who underwent EBUS-TBNA for thoracic lesions (lung masses and hilar/mediastinal lymphadenopathy) over a 10-month period at a single tertiary care centre. In addition to ROSE and definitive cytology, the aspirated material was also sent for cell block and microbiological studies. Endobronchial/transthoracic biopsy was conducted for histopathological evaluation (HPE) where required, at the discretion of the clinician. ROSE diagnosis was then compared with the final diagnosis.
Of the 47 patients examined using ROSE, granulomas were observed in 33 cases, non-specific inflammation in six cases, and malignancy in five cases; one case was inconclusive and the sample was found to be inadequate in two cases. The ROSE assessment matched the final diagnosis in 84.45% patients.
ROSE is a simple procedure that is able to provide an immediate and accurate assessment of adequacy and has a significant yield, enabling a preliminary diagnosis to be made in both benign and malignant samples.
经支气管超声引导针吸活检术（EBUS-TBNA）已成为一种非常有用的工具，可用于精确诊断胸部病变。然而，该操作有时诊断率较低。快速现场评估（ROSE）在 EBUS-TBNA 中已被证明有助于提高其诊断率并减少重复操作的需要。大多数评估 ROSE 效用的研究都集中在恶性病变上；然而，了解其在良性病变中的效用很重要，特别是在结核病负担高的国家。
本研究旨在评估 ROSE 在 EBUS-TBNA 诊断纵隔淋巴结肿大和/或胸内肿块的良恶性病变中的效用。
这是一项前瞻性研究，包括在 10 个月内于一家三级护理中心接受 EBUS-TBNA 检查的 47 名患有胸部病变（肺肿块和肺门/纵隔淋巴结肿大）的患者。除了 ROSE 和明确的细胞学检查外，还将抽吸物送检细胞块和微生物学检查。如果需要，根据临床医生的判断，还进行经支气管/经胸活检以进行组织病理学评估（HPE）。然后将 ROSE 诊断与最终诊断进行比较。
在使用 ROSE 检查的 47 名患者中，33 例观察到肉芽肿，6 例观察到非特异性炎症，5 例观察到恶性肿瘤；1 例结果不确定，2 例结果显示样本不足。ROSE 评估与最终诊断在 84.45%的患者中相匹配。
ROSE 是一种简单的程序，能够立即提供充分性的准确评估，具有显著的诊断率，能够对良性和恶性样本做出初步诊断。
