Alhamar Mohamed, Rudomina Dorota, Wang Lu, Feratovic Rusmir, Oen Handy, Lin Oscar, Wei Xiao-Jun
Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Cancer Cytopathol. 2025 Jan;133(1):e22929. doi: 10.1002/cncy.22929.
Telecytology-assisted rapid on-site evaluation (ROSE) offers a cost-effective method to enhance minimally invasive biopsies like fine needle aspiration and core biopsies with touch preparation. By reducing nondiagnostic sampling and the need for repeat procedures, ROSE via telecytology facilitates prompt triage for ancillary tests, improving patient management. This study examines cases initially deemed adequate for diagnosis during telecytology-assisted ROSE but later categorized as nondiagnostic at final evaluation (NDIS).
We performed a retrospective analysis of telecytology-assisted ROSE cases over 7 years at a major cancer center, focusing on fine needle aspiration and touch preparation of core biopsies. Each case was thoroughly reviewed, correlating with clinical data and concurrent core biopsies or subsequent excisions. The study identified leading factors contributing to NDIS.
The average NDIS rate was 0.06% (42/70,612). Misinterpretation of benign or reactive cells as neoplastic was the leading cause (76.2%) of discrepancies between original ROSE and final diagnosis. Kidney biopsies had the highest NDIS rate (0.90%), primarily because of misinterpreting nonneoplastic cells. Thyroid biopsies were linked to quantitative threshold issues (0.10%). NDIS events were most associated with misinterpretation in kidney, pancreas, gastrointestinal tract, and lung biopsies.
In conclusion, the NDIS rate in telecytology-assisted ROSE is low, but quality assurance identified areas for improvement. Recognizing site-specific pitfalls during telecytology-assisted ROSE can enhance diagnostic accuracy and optimize patient care.
远程细胞学辅助快速现场评估（ROSE）提供了一种经济高效的方法，可通过触摸涂片来增强细针穿刺活检和粗针活检等微创活检。通过减少非诊断性采样和重复操作的需求，远程细胞学辅助的ROSE有助于及时进行辅助检查的分流，改善患者管理。本研究检查了在远程细胞学辅助ROSE期间最初被认为足以诊断，但在最终评估时被归类为非诊断性（NDIS）的病例。
我们对一家大型癌症中心7年间的远程细胞学辅助ROSE病例进行了回顾性分析，重点关注细针穿刺活检和粗针活检的触摸涂片。对每个病例进行了全面审查，并与临床数据以及同期的粗针活检或后续切除标本相关联。该研究确定了导致NDIS的主要因素。
平均NDIS率为0.06%（42/70,612）。将良性或反应性细胞误判为肿瘤性细胞是原始ROSE诊断与最终诊断之间差异的主要原因（7６.2%）。肾脏活检的NDIS率最高（0.90%），主要是因为对非肿瘤性细胞的误判。甲状腺活检与定量阈值问题有关（0.10%）。NDIS事件与肾脏、胰腺、胃肠道和肺部活检中的误判最为相关。
总之，远程细胞学辅助ROSE中的NDIS率较低，但质量保证确定了需要改进的领域。认识到远程细胞学辅助ROSE过程中特定部位的陷阱可以提高诊断准确性并优化患者护理。
