Rapid on-site evaluation combined with endobronchial ultrasound for the diagnosis of pulmonary/mediastinal lesions: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TANG Zhengneng ¹ , GE Jie ² ,  GONG Liming ¹ , WANG Dongkun ¹ , QIU Hao ¹

1. Department of Thoracic and Cardiovascular Surgery, The First People’s Hospital of Kunming City, Kunming, 650034, P. R. China;
2. The First Affiliated Hospital of Kunming Medical University, Kunming, 650532, P. R. China;

Corresponding author：

GONG Liming, Email: Kmliza@126.com

Keywords：

Rapid on-site evaluation; endobronchial ultrasound; needle biopsy; pulmonary lesions; mediastinal lesions; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202211012

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Objective To systematically review the value of rapid on-site evaluation (ROSE) for diagnosing pulmonary and mediastinal lesions with endobronchial ultrasound (EBUS). Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases were searched by computer to collect the studies of ROSE and EBUS in the diagnosis of pulmonary and mediastinal lesions from inception to August 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Meta-analysis was implemented by RevMan 5.4 and Stata 12.0 software. Results A total of 15 studies (9 retrospective studies and 6 prospective studies) with 3 577 patients were included. The meta-analysis results of main outcomes showed that the adequacy of the sample (RD=0.10, 95%CI 0.05 to 0.15, P<0.000 1), overall diagnosis rate (RD=0.07, 95%CI 0.04 to 0.10, P<0.000 1) and the diagnosis rate of the malignant lesion (RD=0.06, 95%CI 0.02 to 0.09, P=0.004) of the ROSE combined with EBUS group were significantly higher than those of the EBUS group. Subgroup analysis showed that the diagnosis rates of pulmonary lesions (RD=0.12, 95%CI 0.08 to 0.17, P<0.000 01) and mediastinal lesions (RD=0.06, 95%CI 0.01 to 0.12, P=0.02) in the ROSE group was significantly higher than those in the EBUS group. The overall diagnosis rate and malignant diagnosis rate of ROSE combined with EBUS were 90% and 92%. The meta-analysis results of secondary outcomes showed that the number of lesions punctures (MD=–1.16, 95%CI –1.89 to –0.43, P=0.002) in the ROSE combined with EBUS group were significantly less than that in the EBUS group; there was no statistical difference in operation time (MD=0.09, 95%CI –5.22 to 5.39, P=0.97) or incidence of complications (RD=–0.06, 95%CI –0.13 to 0.01, P=0.1) between the two groups. Conclusion ROSE can improve the diagnostic efficiency of EBUS in pulmonary and mediastinal lesions, and has the value of the clinical application.

Citation： TANG Zhengneng, GE Jie, GONG Liming, WANG Dongkun, QIU Hao. Rapid on-site evaluation combined with endobronchial ultrasound for the diagnosis of pulmonary/mediastinal lesions: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(7): 1043-1049. doi: 10.7507/1007-4848.202211012 Copy

1.	梁天齐, 张月强. 低剂量螺旋CT对筛查早期肺癌的临床价值及准确性分析. 现代医用影像学, 2022, 31(6): 1061-1064.
2.	Torre M, Reda M, Musso V, et al. Diagnostic accuracy of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging of lung cancer. Mediastinum, 2021, 5: 15.
3.	冯靖. 介入呼吸病学的快速现场评价. 现代实用医学, 2016, 28(1): 5-7.
4.	国家卫计委海峡两岸医药卫生交流协会呼吸病学专业委员会, 中华医学会结核病学分会呼吸内镜专业委员会, 中国医师协会儿科学分会内镜专业委员会, 等. 诊断性介入肺脏病学快速现场评价临床实施指南. 天津医药, 2017, 45(4): 441-448.
5.	Gianella P, Soccal PM, Plojoux J, et al. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration in malignant and nonmalignant disease. Acta Cytol, 2018, 62(5-6): 380-385.
6.	Xu C, Liu W, Wang W, et al. Diagnostic value of endobronchial ultrasound combined with rapid on-site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions. Diagn Cytopathol, 2021, 49(6): 706-710.
7.	Yarmus L, Van der Kloot T, Lechtzin N, et al. A randomized prospective trial of the utility of rapid on-site evaluation of transbronchial needle aspirate specimens. J Bronchology Interv Pulmonol, 2011, 18(2): 121-127.
8.	邬兰, 张永, 曾宪涛. QUADAS-2在诊断准确性研究的质量评价工具中的应用. 湖北医药学院学报, 2013, 32(3): 201-208.
9.	Collins BT, Chen AC, Wang JF, et al. Improved laboratory resource utilization and patient care with the use of rapid on-site evaluation for endobronchial ultrasound fine-needle aspiration biopsy. Cancer Cytopathol, 2013, 121(10): 544-551.
10.	Oki M, Saka H, Kitagawa C, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: A randomized study. Respiration, 2013, 85(6): 486-492.
11.	Chen CH, Cheng WC, Wu BR, et al. Improved diagnostic yield of bronchoscopy in peripheral pulmonary lesions: Combination of radial probe endobronchial ultrasound and rapid on-site evaluation. J Thorac Dis, 2015, 7(Suppl 4): S418-S425.
12.	Guo H, Liu S, Guo J, et al. Rapid on-site evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of hilar and mediastinal lymphadenopathy in patients with lung cancer. Cancer Lett, 2016, 371(2): 182-186.
13.	Cardoso AV, Neves I, Magalhães A, et al. The value of rapid on-site evaluation during EBUS-TBNA. Rev Port Pneumol (2006), 2015, 21(5): 253-258.
14.	Madan K, Dhungana A, Mohan A, et al. Conventional transbronchial needle aspiration versus endobronchial ultrasound-guided transbronchial needle aspiration, with or without rapid on-site evaluation, for the diagnosis of sarcoidosis: A randomized controlled trial. J Bronchology Interv Pulmonol, 2017, 24(1): 48-58.
15.	Xu CH, Wang JW, Wang W, et al. The diagnosis value of endobronchial ultrasound transbronchial lung biopsy combined with rapid on-site evaluation in peripheral lung cancer. Clin Respir J, 2020, 14(5): 447-452.
16.	Qi JC, Liao L, Zhao Z, et al. Impact of rapid on-site evaluation combined with endobronchial ultrasound and virtual bronchoscopic navigation in diagnosing peripheral lung lesions. BMC Pulm Med, 2022, 22(1): 117.
17.	张磊, 叶联华, 陈颖, 等. 现场快速评估在经超声支气管镜针吸活检中的应用评价. 中国当代医药, 2017, 24(24): 7-10.
18.	向青, 万涛, 胡前方, 等. 快速现场细胞学评价在EBUS-TBNA取样诊断肺癌中的价值. 中国肺癌杂志, 2018, 21(11): 833-840.
19.	陈伟庄, 王辉, 李优, 等. 快速现场评价在经气管镜超声引导针吸活检诊断纵隔病灶中的应用. 中国内镜杂志, 2021, 27(4): 44-51.
20.	张凯峰. EBUS-TBNA联合ROSE诊断纵隔/肺门淋巴结肿大的应用价值研究. 吉林大学, 2020.
21.	张禄琴. 超声引导下经支气管针吸活检结合快速现场评估对纵隔、肺门病变的临床应用价值. 宁夏医科大学, 2021.
22.	Miller KD, Goding Sauer A, Ortiz AP, et al. Cancer statistics for hispanics/latinos, 2018. CA Cancer J Clin, 2018, 68(6): 425-445.
23.	王哲, 吴齐飞, 张广健, 等. 电视纵隔镜手术应用于胸外科40例. 中国胸心血管外科临床杂志, 2017, 24(12): 957-961.
24.	刘海燕, 刘杰, 宋健, 等. 超声支气管镜引导下针吸活检术对纵隔及肺部病变诊断价值. 现代仪器与医疗, 2018, 24(6): 40-41, 90.
25.	Mehta AC, Wang KP. Teaching conventional transbronchial needle aspiration. A continuum. Ann Am Thorac Soc, 2013, 10(6): 685-689.
26.	Sørhaug S, Hjelde H, Hatlen P, et al. Learning endobronchial ultrasound transbronchial needle aspiration—A 6-year experience at a single institution. Clin Respir J, 2018, 12(1): 40-47.
27.	Sehgal IS, Dhooria S, Aggarwal AN, et al. Impact of rapid on-site cytological evaluation (ROSE) on the diagnostic yield of transbronchial needle aspiration during mediastinal lymph node sampling: Systematic review and meta-analysis. Chest, 2018, 153(4): 929-938.
28.	金旭如, 陈成水. 浅谈快速现场评价在呼吸系统疾病诊断中的应用. 中华结核和呼吸杂志, 2018, 41(6): 507-508.
29.	Chen X, Wan B, Xu Y, et al. Efficacy of rapid on-site evaluation for diagnosing pulmonary lesions and mediastinal lymph nodes: A systematic review and meta-analysis. Transl Lung Cancer Res, 2019, 8(6): 1029-1044.

1. 梁天齐, 张月强. 低剂量螺旋CT对筛查早期肺癌的临床价值及准确性分析. 现代医用影像学, 2022, 31(6): 1061-1064.
2. Torre M, Reda M, Musso V, et al. Diagnostic accuracy of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging of lung cancer. Mediastinum, 2021, 5: 15.
3. 冯靖. 介入呼吸病学的快速现场评价. 现代实用医学, 2016, 28(1): 5-7.
4. 国家卫计委海峡两岸医药卫生交流协会呼吸病学专业委员会, 中华医学会结核病学分会呼吸内镜专业委员会, 中国医师协会儿科学分会内镜专业委员会, 等. 诊断性介入肺脏病学快速现场评价临床实施指南. 天津医药, 2017, 45(4): 441-448.
5. Gianella P, Soccal PM, Plojoux J, et al. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration in malignant and nonmalignant disease. Acta Cytol, 2018, 62(5-6): 380-385.
6. Xu C, Liu W, Wang W, et al. Diagnostic value of endobronchial ultrasound combined with rapid on-site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions. Diagn Cytopathol, 2021, 49(6): 706-710.
7. Yarmus L, Van der Kloot T, Lechtzin N, et al. A randomized prospective trial of the utility of rapid on-site evaluation of transbronchial needle aspirate specimens. J Bronchology Interv Pulmonol, 2011, 18(2): 121-127.
8. 邬兰, 张永, 曾宪涛. QUADAS-2在诊断准确性研究的质量评价工具中的应用. 湖北医药学院学报, 2013, 32(3): 201-208.
9. Collins BT, Chen AC, Wang JF, et al. Improved laboratory resource utilization and patient care with the use of rapid on-site evaluation for endobronchial ultrasound fine-needle aspiration biopsy. Cancer Cytopathol, 2013, 121(10): 544-551.
10. Oki M, Saka H, Kitagawa C, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: A randomized study. Respiration, 2013, 85(6): 486-492.
11. Chen CH, Cheng WC, Wu BR, et al. Improved diagnostic yield of bronchoscopy in peripheral pulmonary lesions: Combination of radial probe endobronchial ultrasound and rapid on-site evaluation. J Thorac Dis, 2015, 7(Suppl 4): S418-S425.
12. Guo H, Liu S, Guo J, et al. Rapid on-site evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of hilar and mediastinal lymphadenopathy in patients with lung cancer. Cancer Lett, 2016, 371(2): 182-186.
13. Cardoso AV, Neves I, Magalhães A, et al. The value of rapid on-site evaluation during EBUS-TBNA. Rev Port Pneumol (2006), 2015, 21(5): 253-258.
14. Madan K, Dhungana A, Mohan A, et al. Conventional transbronchial needle aspiration versus endobronchial ultrasound-guided transbronchial needle aspiration, with or without rapid on-site evaluation, for the diagnosis of sarcoidosis: A randomized controlled trial. J Bronchology Interv Pulmonol, 2017, 24(1): 48-58.
15. Xu CH, Wang JW, Wang W, et al. The diagnosis value of endobronchial ultrasound transbronchial lung biopsy combined with rapid on-site evaluation in peripheral lung cancer. Clin Respir J, 2020, 14(5): 447-452.
16. Qi JC, Liao L, Zhao Z, et al. Impact of rapid on-site evaluation combined with endobronchial ultrasound and virtual bronchoscopic navigation in diagnosing peripheral lung lesions. BMC Pulm Med, 2022, 22(1): 117.
17. 张磊, 叶联华, 陈颖, 等. 现场快速评估在经超声支气管镜针吸活检中的应用评价. 中国当代医药, 2017, 24(24): 7-10.
18. 向青, 万涛, 胡前方, 等. 快速现场细胞学评价在EBUS-TBNA取样诊断肺癌中的价值. 中国肺癌杂志, 2018, 21(11): 833-840.
19. 陈伟庄, 王辉, 李优, 等. 快速现场评价在经气管镜超声引导针吸活检诊断纵隔病灶中的应用. 中国内镜杂志, 2021, 27(4): 44-51.
20. 张凯峰. EBUS-TBNA联合ROSE诊断纵隔/肺门淋巴结肿大的应用价值研究. 吉林大学, 2020.
21. 张禄琴. 超声引导下经支气管针吸活检结合快速现场评估对纵隔、肺门病变的临床应用价值. 宁夏医科大学, 2021.
22. Miller KD, Goding Sauer A, Ortiz AP, et al. Cancer statistics for hispanics/latinos, 2018. CA Cancer J Clin, 2018, 68(6): 425-445.
23. 王哲, 吴齐飞, 张广健, 等. 电视纵隔镜手术应用于胸外科40例. 中国胸心血管外科临床杂志, 2017, 24(12): 957-961.
24. 刘海燕, 刘杰, 宋健, 等. 超声支气管镜引导下针吸活检术对纵隔及肺部病变诊断价值. 现代仪器与医疗, 2018, 24(6): 40-41, 90.
25. Mehta AC, Wang KP. Teaching conventional transbronchial needle aspiration. A continuum. Ann Am Thorac Soc, 2013, 10(6): 685-689.
26. Sørhaug S, Hjelde H, Hatlen P, et al. Learning endobronchial ultrasound transbronchial needle aspiration—A 6-year experience at a single institution. Clin Respir J, 2018, 12(1): 40-47.
27. Sehgal IS, Dhooria S, Aggarwal AN, et al. Impact of rapid on-site cytological evaluation (ROSE) on the diagnostic yield of transbronchial needle aspiration during mediastinal lymph node sampling: Systematic review and meta-analysis. Chest, 2018, 153(4): 929-938.
28. 金旭如, 陈成水. 浅谈快速现场评价在呼吸系统疾病诊断中的应用. 中华结核和呼吸杂志, 2018, 41(6): 507-508.
29. Chen X, Wan B, Xu Y, et al. Efficacy of rapid on-site evaluation for diagnosing pulmonary lesions and mediastinal lymph nodes: A systematic review and meta-analysis. Transl Lung Cancer Res, 2019, 8(6): 1029-1044.

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Rapid on-site evaluation combined with endobronchial ultrasound for the diagnosis of pulmonary/mediastinal lesions: A systematic review and meta-analysis

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