Department of Pulmonary and Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Department of Laboratory Medicine, Baoshan District of Huashan Hospital, Fudan University, Shanghai, China.
Cytopathology. 2022 Jul;33(4):439-444. doi: 10.1111/cyt.13123. Epub 2022 May 10.
The efficacy of rapid on-site evaluation (ROSE) combined with computed tomography-guided transthoracic core needle biopsy (CT-guided TCNB) is rarely investigated. This study aimed to evaluate the diagnostic efficiency and safety of ROSE combined with CT-guided TCNB for suspected lung cancer patients.
Clinical data from 285 patients who received CT-guided TCNB for suspected lung cancer in Huashan Hospital from 2015 to 2018 were retrospectively analysed. Of these 163 patients underwent CT-guided TCNB combined with ROSE (ROSE group), while the remaining 122 patients underwent without ROSE (non-ROSE group). The smears from TCNB were quickly processed with Diff-Quick staining and analysed by a skilled cytologist on-site. The consistency of ROSE with the final clinicopathological diagnosis and the diagnostic efficiency and safety of ROSE combined with CT-guided TCNB in suspected lung cancer patients were evaluated.
ROSE was highly concordant with pathological diagnosis (κ = 0.791; P < 0.001), with an accuracy of 95.7%. Diagnostic accuracy was significantly higher in the ROSE compared with the non-ROSE group (96.3% vs 86.1%; P = 0.002), with overall incidences of complications of 36.8% and 23.8%, respectively. Minor pneumothorax without drainage was slightly greater in the ROSE compared with the non-ROSE group (14.1% vs 6.6%; P = 0.046). However, there was no significant difference in serious complications between the two groups.
ROSE was highly consistent with the final clinicopathological diagnosis for suspected lung cancer. ROSE further improved the diagnostic efficiency of CT-guided TCNB with no increased incidence of serious complications.
快速现场评估（ROSE）联合 CT 引导下经胸穿芯针活检（CT 引导 TCNB）的疗效鲜有报道。本研究旨在评估 ROSE 联合 CT 引导 TCNB 对疑似肺癌患者的诊断效果和安全性。
回顾性分析 2015 年至 2018 年华山医院 285 例疑似肺癌患者行 CT 引导 TCNB 的临床资料。其中 163 例行 CT 引导 TCNB 联合 ROSE（ROSE 组），122 例行单纯 CT 引导 TCNB（非 ROSE 组）。将 TCNB 标本用 Diff-Quick 快速染色，由熟练的细胞学医生现场分析。评估 ROSE 与最终临床病理诊断的一致性，以及 ROSE 联合 CT 引导 TCNB 对疑似肺癌患者的诊断效果和安全性。
ROSE 与病理诊断高度一致（κ=0.791；P<0.001），准确率为 95.7%。ROSE 组的诊断准确率显著高于非 ROSE 组（96.3%比 86.1%；P=0.002），总体并发症发生率分别为 36.8%和 23.8%。ROSE 组轻度气胸无需引流的发生率略高于非 ROSE 组（14.1%比 6.6%；P=0.046）。但两组严重并发症发生率无显著差异。
ROSE 与疑似肺癌的最终临床病理诊断高度一致。ROSE 进一步提高了 CT 引导 TCNB 的诊断效率，且不增加严重并发症的发生率。
