Chen Ying-Yi, Huang Hsin-Ya, Lin Chi-Yi, Chen Kuan-Liang, Huang Tsai-Wang
Graduate Institute of Medical Science, National Defense Medical Center, Taipei 114, Taiwan.
Division of Thoracic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
J Pers Med. 2022 Mar 13;12(3):451. doi: 10.3390/jpm12030451.
Introduction: This study aimed to verify the predictors of the diagnostic accuracy of rapid on-site evaluation (ROSE) in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) among patients with non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed consecutive patients with NSCLC who underwent EBUS-TBNA for staging or diagnosis at our hospital from June 2016 to June 2018. The patients were divided into two groups—those with a correct diagnosis and an incorrect diagnosis after ROSE. Kaplan−Meier plots and log-rank tests were used to estimate outcomes. Results: A total of 84 patients underwent EBUS-TBNA for staging and diagnosis. Sixty patients with demonstrated malignant mediastinal lymph nodes were enrolled. In the univariate analysis, lymph nodes < 1.5 cm (HR = 3.667, p = 0.031) and a SUVmax > 5 (HR = 41, p = 0.001) were statistically significant for diagnostic accuracy of ROSE. In the multivariate Cox regression analysis, only a SUVmax > 5 (HR = 20.258, p = 0.016) was statistically significant. Conclusions: A SUVmax > 5 is an independent predictor of higher diagnostic accuracy of ROSE in EBUS-TBNA in patients with NSCLC with malignant mediastinal lymph nodes. Therefore, ROSE in patients with a SUVmax < 5 might not be reliable and requires further prudent assessment (more shots or repeated biopsies at mediastinal LNs) in clinical practice.
本研究旨在验证非小细胞肺癌（NSCLC）患者经支气管超声引导针吸活检术（EBUS-TBNA）中快速现场评估（ROSE）诊断准确性的预测因素。方法：我们回顾性分析了2016年6月至2018年6月在我院接受EBUS-TBNA进行分期或诊断的连续NSCLC患者。患者分为两组——ROSE后诊断正确组和诊断错误组。采用Kaplan-Meier曲线和对数秩检验评估结果。结果：共有84例患者接受EBUS-TBNA进行分期和诊断。纳入60例显示纵隔淋巴结为恶性的患者。单因素分析中，淋巴结<1.5 cm（HR = 3.667，p = 0.031）和SUVmax>5（HR = 41，p = 0.001）对ROSE的诊断准确性具有统计学意义。多因素Cox回归分析中，仅SUVmax>5（HR = 20.258，p = 0.016）具有统计学意义。结论：SUVmax>5是NSCLC伴纵隔淋巴结转移患者EBUS-TBNA中ROSE诊断准确性较高的独立预测因素。因此，SUVmax<5的患者中ROSE可能不可靠，临床实践中需要进一步谨慎评估（对纵隔淋巴结进行更多穿刺或重复活检）。
