The role of rapid on-site evaluation in the diagnosis of lung space-occupying lesions_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LI Yan ¹ , CAI Hourong ¹ , YAN Xin ¹ , GAO Yujuan ¹ , BAI Tao ² , ZHENG Jinyu ² ,  DAI Jinghong ¹

1. Department of Respiratory Medicine, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, P. R. China;
2. Department of Pathology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, P. R. China;

Corresponding author：

DAI Jinghong, Email: 23568@sina.com

Keywords：

Rapid on-site evaluation; Lung space-occupying lesion; Bronchoscopy; Pulmonologist

DOI：

10.7507/1671-6205.201803043

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ObjectiveTo evaluate the role of rapid on-site evaluation (ROSE) in the diagnosis of lung space-occupying lesions.MethodsFrom June 1, 2017 to December 30, 2017, transbronchial biopsies were performed in patients with lung space-occupying lesions on chest CT, and biopsies were taken for ROSE and subsequent routine pathological examination. ROSE interpretation was performed by a pulmonologist who had been trained in cytopathology for 3 months. The interpretation was correlated with the follow-up routine pathological examination. The contemporary cases with lung space-occupying lesions who underwent transbronchial biopsies without ROSE were retrospectively reviewed. The quality assessment of biopsy specimens recorded in pathological reports were compared between cases with and without ROSE.ResultsA total of 101 patients underwent transbronchial biopsies in parallel with ROSE. The interpretation results of the pulmonologist were compared with the follow-up routine pathology, which showed that the consistency rate of malignant lesions was 84.1% and the consistency rate of benign lesions was 93.8%. Consistency test showed good agreement between the ROSE conducted by the pulmonologist and the routine pathological examination by pathologists (κ=0.66, P<0.01). The quality assessment of biopsy specimens showed that there was no significant difference on rate of satisfied biopsy specimens between cases with and without ROSE (98.0%vs 94.5%, P=0.14).ConclusionsThe use of ROSE combining with bronchoscopy allows good preliminary assessment of lung space-occupying lesions. Pulmonologists trained in short-term formal cytopathology are fully capable of performing ROSE, thereby obviating the need for cytopathologists to participate in on-site evaluation.

Citation： LI Yan, CAI Hourong, YAN Xin, GAO Yujuan, BAI Tao, ZHENG Jinyu, DAI Jinghong. The role of rapid on-site evaluation in the diagnosis of lung space-occupying lesions. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(5): 484-487. doi: 10.7507/1671-6205.201803043 Copy

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1. 赵丽娟, 朱辉, 王可, 等. 2670 例肺癌支气管镜下表现与病理类型的关系分析. 中国呼吸与危重监护杂志, 2009, 8(3): 287-289.
2. Papanicolaou Society of Cytopathology Task Force on Standards of Practice. Guidelines of the Papanicolaou Society of Cytopathology for the examination of cytologic specimens obtained from the respiratory tract. Diagn Cytopathol, 1999, 21: 61-69.
3. Koul A, Baxi AC, Shang R, et al. The efficacy of rapid on-site evaluation during endoscopic ultrasound-guided fine needle aspiration of pancreatic masses. Gastroenterol Rep (Oxf), 2018, 6(1): 45-48.
4. Naïm C, Karam R, Eddam R Ultrasound-guided fine-needle aspiration biopsy of the thyroid: methods to decrease the rate of unsatisfactory biopsies in the absence of an on-site pathologist. Ultrasound-guided fine-needle aspiration biopsy of the thyroid: methods to decrease the rate of unsatisfactory biopsies in the absence of an on-site pathologist. Can Assoc Radiol J, 2013, 64(3): 220-225.
5. Pak HY, Yokota S, Teplitz RL, et al. Rapid staining techniques employed in fine needle aspirations of the lung. Acta Cytol, 1981, 25(2): 178-184.
6. Davenport RD. Rapid on-site evaluation of transbronchial aspirates. Chest, 1990, 98(1): 59-61.
7. Asano F, Eberhardt R, Herth FJ. Virtual bronchoscopic navigation for peripheral pulmonary lesions. Respiration, 2014, 88(5): 430-440.
8. Zaric B, Stojsic V, Sarcev T, et al. Advanced bronchoscopic techniques in diagnosis and staging of lung cancer. J Thorac Dis, 2013, 5 Suppl 4: S359-S370.
9. Bonifazi M, Sediari M, Ferretti M, et al. The role of the pulmonologist in rapid on-site cytologic evaluation of transbronchial needle aspiration: a prospective study. Chest, 2014, 145(1): 60-65.

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The role of rapid on-site evaluation in the diagnosis of lung space-occupying lesions

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