Gilbert Christopher R, Dust Claire, Argento A Christine, Feller-Kopman David, Gonzalez Anne V, Herth Felix, Iaccarino Jonathan M, Illei Peter, O'Neil Kevin, Pastis Nicholas, Rivera M Patricia, Sholl Lynette, Silvestri Gerard A, Thiboutot Jeffrey, Wahidi Momen M, Yasafuku Kazuhiro, Yarmus Lonny B
Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC.
American College of Chest Physicians, Glenview, IL.
Chest. 2025 Mar;167(3):899-909. doi: 10.1016/j.chest.2024.08.056. Epub 2024 Sep 27.
Endobronchial ultrasound-guided transbronchial aspiration (EBUS-TBNA) has become the standard for initial lung cancer diagnosis and staging. Previous guidelines have generally focused on the "when" and "how" of EBUS-TBNA; however, little guidance is available on handling and processing specimens during and after acquisition to help optimize both diagnostic yield and tissue integrity for ancillary studies. This document examines the available literature on EBUS-TBNA specimen processing and handling.
Rigorous methodology was applied to provide a trustworthy evidence-based guideline and expert panel report. Panelists developed key clinical questions using the Population, Intervention, Comparator, and Outcome format, addressing specific topics in EBUS-TBNA specimen processing. MEDLINE (via PubMed) and the Cochrane Library were systematically searched to identify relevant literature, supplemented by manual searches. References were screened for inclusion with document evaluation tools to assess the quality of included studies, extract meaningful data, and grade the level of evidence to support each recommendation or suggestion.
Our systematic review and critical analysis of the literature of the nine Population, Intervention, Comparator, and Outcome questions related to handling and processing EBUS-TBNA specimens resulted in nine evidence-based statements.
Evidence of the handling and processing of EBUS-TBNA specimens varies in strength but is satisfactory in some areas to guide clinicians in certain aspects of specimen handling. Additional research in many aspects of specimen handling and processing is needed to help improve our knowledge base.
支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）已成为肺癌初始诊断和分期的标准方法。以往的指南通常侧重于EBUS-TBNA的“时机”和“操作方法”；然而，关于采集过程中及采集后标本的处理和加工，几乎没有相关指导，以帮助优化诊断率和辅助研究的组织完整性。本文献探讨了有关EBUS-TBNA标本处理和加工的现有文献。
应用严格的方法以提供一份可靠的循证指南和专家小组报告。小组成员采用人群、干预措施、对照和结局格式提出关键临床问题，涉及EBUS-TBNA标本处理的具体主题。通过系统检索MEDLINE（通过PubMed）和Cochrane图书馆以识别相关文献，并辅以手工检索。使用文献评估工具筛选参考文献以纳入研究，评估纳入研究的质量，提取有意义的数据，并对支持每项推荐或建议的证据水平进行分级。
我们对与EBUS-TBNA标本处理和加工相关的九个“人群、干预措施、对照和结局”问题的文献进行系统综述和批判性分析，得出了九条循证陈述。
EBUS-TBNA标本处理和加工的证据强度各不相同，但在某些方面足以指导临床医生进行标本处理的某些方面。在标本处理和加工的许多方面还需要进一步研究，以帮助完善我们的知识库。
