Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas.
Department of Pathololgy & Immunology, Baylor College of Medicine, Houston, Texas.
J Am Soc Cytopathol. 2022 Sep-Oct;11(5):328-333. doi: 10.1016/j.jasc.2022.06.002. Epub 2022 Jun 8.
Rapid on-site evaluation (ROSE) performed during endobronchial ultrasound-guided fine needle aspiration (EBUS-FNA) has shown significant value. However, ROSE may not be available for some pulmonary centers. Performing ROSE can be challenging and stressful due to time constrains for preparing, staining and reviewing the cytology slides between passes.
A retrospective cytology report review of EBUS-FNA procedures performed between October 2014 and May 2019 revealed 516 cases that were included in the study. The number of passes for each procedure was documented. The adequacy rates were assessed at 4 different study points; ≤3 passes, ≤5 passes, at odd passes only, and the even passes only. The study groups results were compared to the overall ROSE and the final cytology adequacy.
The overall ROSE interpretation was adequate in 370 (71.7%) and inadequate in 146 (28.3%). After reviewing the Papanicolaou stained slides and cell blocks, the final cytology results were adequate in 473 (91.7%) and inadequate in 43 (8.3%) of the cases. The number of passes per procedure ranged from 1 to 17. Our results showed that ROSE evaluation of the first 5 passes during the EBUS-FNA procedure could achieve the similar adequacy rate compared to the overall ROSE evaluation of all the passes.
To achieve the most benefits of ROSE and to reduce the procedure time for EBUS-FNA, we recommend performing ROSE for ≤5 passes depending on the adequacy, and save all additional passes for cell blocks preparation if more than 5 passes are attempted.
在支气管内超声引导下细针抽吸术（EBUS-FNA）中进行快速现场评估（ROSE）已显示出重要价值。然而，由于在通过之间准备、染色和审查细胞学载玻片的时间限制，一些肺部中心可能无法获得 ROSE。由于准备、染色和审查细胞学载玻片之间的时间限制，ROSE 的执行可能具有挑战性和压力。
回顾性分析 2014 年 10 月至 2019 年 5 月间进行的 EBUS-FNA 程序的细胞学报告，发现 516 例纳入研究。记录了每个程序的通过次数。在 4 个不同的研究点评估了充足率；≤3 次，≤5 次，奇数通过仅，偶数通过仅。将研究组的结果与总体 ROSE 和最终细胞学充足率进行比较。
总体 ROSE 解释在 370 例（71.7%）中是充足的，在 146 例（28.3%）中是不充足的。在回顾巴氏染色的载玻片和细胞块后，最终细胞学结果在 473 例（91.7%）中是充足的，在 43 例（8.3%）中是不充足的。每个程序的通过次数从 1 次到 17 次不等。我们的结果表明，在 EBUS-FNA 过程中，前 5 次通过的 ROSE 评估可以达到与所有通过的总体 ROSE 评估相似的充足率。
为了最大限度地受益于 ROSE 并减少 EBUS-FNA 的程序时间，我们建议根据充足性进行 ROSE 评估≤5 次，如果尝试超过 5 次，则保存所有额外的通过次数用于细胞块制备。
