Departments of Pulmonology.
Pathology, Koc University Hospital, Istanbul, Turkey.
J Bronchology Interv Pulmonol. 2022 Jul 1;29(3):191-197. doi: 10.1097/LBR.0000000000000809. Epub 2021 Sep 9.
The cost-effectiveness and low rate of inadequate sampling with the use of rapid on-site evaluation (ROSE) along with endobronchial ultrasonography (EBUS) is well established. Our aim in this study was to evaluate the correlation of ROSE during EBUS and final cytologic diagnosis and also to see if ROSE might predict the subtype of lung cancer.
All consecutive subjects who attended our clinic between January 2016 and January 2019 for the evaluation of pathologic mediastinal and/or hilar lymph nodes (LNs)/mass using EBUS were enrolled into our prospective study. ROSE was performed in the same operating room with EBUS. ROSE results during EBUS were recorded. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ROSE compared with the final cytologic diagnosis were evaluated.
We enrolled 684 LN/mass lesions belonging to 328 patients into this study. When we compared ROSE results and final cytologic diagnosis, these procedures agreed on 91.6% of the LNs (P<0.001). The sensitivity of ROSE and final cytologic diagnosis for granulomatous inflammation was 72.5%, and for lung cancer, it was 89.2% (P<0.001). The sensitivity of ROSE for the adenocarcinoma subtype of lung cancer was 67.7%, and it was 70% for small cell lung cancer.
ROSE may help to recognize non-small cell lung cancer during EBUS, especially the adenocarcinoma subtype of lung cancer, which will help ensure having sufficient material for molecular analysis.
快速现场评估(ROSE)联合支气管内超声(EBUS)的成本效益高,且组织取样不足的发生率低,这一点已得到充分证实。本研究旨在评估 ROSE 与最终细胞学诊断的相关性,以及 ROSE 是否可以预测肺癌的亚型。
本前瞻性研究纳入了 2016 年 1 月至 2019 年 1 月期间因病理性纵隔和/或肺门淋巴结(LNs)/肿块而在我科接受 EBUS 评估的所有连续患者。ROSE 在 EBUS 手术室进行。记录 EBUS 过程中的 ROSE 结果。评估 ROSE 与最终细胞学诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性。
本研究共纳入了 328 例患者的 684 个 LN/肿块病变。当比较 ROSE 结果和最终细胞学诊断时,两种方法在 91.6%的 LN 上一致(P<0.001)。ROSE 和最终细胞学诊断对肉芽肿性炎症的敏感性分别为 72.5%和 89.2%(P<0.001)。ROSE 对肺腺癌亚型的敏感性为 67.7%,对小细胞肺癌的敏感性为 70%。
ROSE 可帮助识别 EBUS 中的非小细胞肺癌,特别是肺腺癌亚型,这将有助于确保有足够的材料进行分子分析。