Background: Most of the patients with lung and (or) mediastinal occupying lesions are considered to be primary lung cancer clinically, and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a commonly useful operation to obtain the tissue sample and get definitive diagnosis of pathological tissues. In the EBUS-TBNA process, cytological rapid on-site evaluation (C-ROSE) is a useful technology. The purpose of our study is to discuss the value of C-ROSE in the diagnosis of lung cancer by EBUS-TBNA sampling.
Methods: Retrospective analysis of 141 cases clinical data who were performed with EBUS-TBNA and suspected diagnosis primary lung cancer, which were found have mediastinal and (or) lung lesions (including the enlargement of the lymph nodes/mass) by computed tomography (CT). Among these patients, 81 patients were in the C-ROSE group and 60 patients were in the No C-ROSE group. The message of puncture and complication of EBUS-TBNA with or without C-ROSE were compared. At the same time, we analysis the sensitivity and specificity, positive predictive value, negative predictive value of C-ROSE combined with EBUS-TBNA in that of the diagnosis of lung cancer.
Results: We found no statistical difference of the needle passes between C-ROSE group and No C-ROSE group. But in C-ROSE group, specimen qualified rate and diagnostic yields were signicantly higher than No C-ROSE group (98.77% vs 90.00%, 88.89% vs 75.00%, P<0.05), the incidence of complications in the C-ROSE group was signicantly lower than that in the No C-ROSE group (1.23% vs 11.67%, P<0.05). The sensitivity, specificity, positive predictive value and negative predictive value of C-ROSE combined with EBUS-TBNA in the diagnosis of lung cancer are 92.21%, 100.00%, 100.00% and 40.00%.
Conclusions: EBUS-TBNA combined with C-ROSE can improve the specimen qualified rate and diagnostic rate, also can reduce the complications thus worthy of further promotion.
【中文题目：快速现场细胞学评价在EBUS-TBNA取样诊断肺癌中的价值】 【中文摘要：背景与目的 在肺及纵隔占位性病变的患者中大部分临床考虑诊断为原发性肺癌，超声支气管镜引导下的经支气管针吸活检术（endobronchial ultrasound-guided transbronchial needle aspiration, EBUS-TBNA）是一种常用的获取病理组织明确诊断的手术。在EBUS-TBNA过程中，快速现场细胞学评价（cytological rapid on-site evaluation, C-ROSE）是一项有用的辅助技术。本研究探讨C-ROSE在EBUS-TBNA取样诊断肺癌中的价值。方法 对141例经胸部计算机断层扫描（computed tomography, CT）发现存在纵隔和（或）肺门病灶（包括肿大的淋巴结/肿块）且临床高度疑诊原发性肺癌而行EBUS-TBNA患者进行回顾性分析，其中术中行C-ROSE者81例，未行C-ROSE者60例，分析两组患者的穿刺情况及并发症发生率，同时分析C-ROSE联合EBUS-TBNA取样对肺癌诊断的敏感度、特异度、阳性预测值、阴性预测值。结果 C-ROSE组与非C-ROSE组穿刺针数及穿刺部位数无统计学差异，穿刺合格率分别为98.77%和90.00%（P<0.05），诊断率分别为88.89%和75.00%（P<0.05），并发症发生率分别为1.23%和11.67%（P<0.05）。C-ROSE联合EBUS-TBNA对肺癌诊断的敏感度为92.21%，特异度为100.00%，阳性预测值为100.00%，阴性预测值为40.00%。结论 C-ROSE在疑诊肺癌行EBUS-TBNA中应用可以提高穿刺成功率及诊断率、减少并发症，值得推广。】 【中文关键词：超声支气管镜引导下的经支气管针吸活检术；快速现场细胞学评价；肺肿瘤】.
Keywords: Cytological rapid on-site evaluation; Endobronchial ultrasound-guided transbronchial needle aspiration; Lung neoplasms.