Shuang Yan , Lei Pan , Jian Chen , Hua Jiang , Li Gong , Faguang Jin
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The final pathological results and the number of patients undergoing repeat biopsies were recorded in both groups. Specifically, we conducted separate statistical analysis for patients undergoing different biopsy methods, including the endobronchial biopsy (EBB), radial probe endobronchial ultrasound transbronchial </span>lung biopsy with guide sheath (r-EBUS-GS-TBLB), and the endobronchial ultrasound-guided </span>transbronchial needle aspiration (EBUS-TBNA) to study the detailed roles that ROSE plays under different biopsy methods.</p></div><div><h3>Results</h3><p>The adequacy rate of biopsy specimens from the non-ROSE group was significantly lower than that of the ROSE group (259/281 = 92.17 % vs. 263/268 = 98.13 %, p = 0.001). Meanwhile, fewer patients underwent repeat biopsies in the ROSE group compared to the non-ROSE group (2/294 = 0.68 % vs. 10/304 = 3.29 %, p = 0.023). For the ROSE group, the consistency between ROSE diagnoses and final pathological diagnoses was 94.40 % (κ = 0.886), with 95.58 % for benign diseases and 93.55 % for malignant diseases.</p></div><div><h3>Conclusion</h3><p>The utility of ROSE during FB increases the adequacy rate of biopsy specimens and thus decreases the need for repeat biopsies in patients with lung lesions to get a definite diagnosis. Moreover, the high consistency between ROSE diagnoses and final pathological diagnoses suggests that ROSE is a reliable tool for optimizing the diagnosis of lung lesions.</p></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Application of rapid on-site evaluation combined with flexible bronchoscopy in the diagnosis of lung lesions\",\"authors\":\"Shuang Yan , Lei Pan , Jian Chen , Hua Jiang , Li Gong , Faguang Jin\",\"doi\":\"10.1016/j.anndiagpath.2023.152261\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Pathology is considered the gold standard for the diagnosis of lung lesions<span>, but the pathological result is relatively lagging and cannot provide real-time guidance for the biopsy procedure.</span></p></div><div><h3>Objective</h3><p>To investigate the potential application of rapid on-site evaluation (ROSE) during flexible bronchoscopy (FB) in the evaluation and diagnosis of lung lesions.</p></div><div><h3>Patients and methods</h3><p><span><span>Consecutive patients who underwent FB for the diagnosis of lung lesions between August 2022 and February 2023 were included in this retrospective study. 294 patients underwent FB with ROSE, while 304 patients underwent FB without ROSE. The final pathological results and the number of patients undergoing repeat biopsies were recorded in both groups. Specifically, we conducted separate statistical analysis for patients undergoing different biopsy methods, including the endobronchial biopsy (EBB), radial probe endobronchial ultrasound transbronchial </span>lung biopsy with guide sheath (r-EBUS-GS-TBLB), and the endobronchial ultrasound-guided </span>transbronchial needle aspiration (EBUS-TBNA) to study the detailed roles that ROSE plays under different biopsy methods.</p></div><div><h3>Results</h3><p>The adequacy rate of biopsy specimens from the non-ROSE group was significantly lower than that of the ROSE group (259/281 = 92.17 % vs. 263/268 = 98.13 %, p = 0.001). Meanwhile, fewer patients underwent repeat biopsies in the ROSE group compared to the non-ROSE group (2/294 = 0.68 % vs. 10/304 = 3.29 %, p = 0.023). For the ROSE group, the consistency between ROSE diagnoses and final pathological diagnoses was 94.40 % (κ = 0.886), with 95.58 % for benign diseases and 93.55 % for malignant diseases.</p></div><div><h3>Conclusion</h3><p>The utility of ROSE during FB increases the adequacy rate of biopsy specimens and thus decreases the need for repeat biopsies in patients with lung lesions to get a definite diagnosis. 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引用次数: 0
摘要
背景病理学被认为是诊断肺部病变的金标准,但病理结果相对滞后,不能为活检手术提供实时指导。目的探讨在柔性支气管镜(FB)检查过程中快速现场评估(ROSE)在肺部病变评估和诊断中的潜在应用。患者和方法这项回顾性研究纳入了2022年8月至2023年2月期间接受FB检查诊断肺部病变的连续患者。其中,294 名患者接受了带有 ROSE 的 FB,304 名患者接受了不带 ROSE 的 FB。两组患者的最终病理结果和接受重复活检的患者人数均有记录。具体而言,我们对采用不同活检方法的患者分别进行了统计分析,包括支气管内活检(EBB)、带导引鞘的径向探头支气管内超声经支气管肺活检(r-EBUS-GS-TBLB)和支气管内超声引导下经支气管针吸术(EBUS-TBNA),以研究 ROSE 在不同活检方法中的具体作用。结果 非ROSE组活检标本的充分率明显低于ROSE组(259/281 = 92.17 % vs. 263/268 = 98.13 %,P = 0.001)。同时,与非 ROSE 组相比,ROSE 组接受重复活检的患者更少(2/294 = 0.68 % vs. 10/304 = 3.29 %,p = 0.023)。在 ROSE 组中,ROSE 诊断与最终病理诊断的一致性为 94.40 %(κ = 0.886),其中良性疾病为 95.58 %,恶性疾病为 93.55 %。此外,ROSE 诊断与最终病理诊断之间的高度一致性表明,ROSE 是优化肺部病变诊断的可靠工具。
Application of rapid on-site evaluation combined with flexible bronchoscopy in the diagnosis of lung lesions
Background
Pathology is considered the gold standard for the diagnosis of lung lesions, but the pathological result is relatively lagging and cannot provide real-time guidance for the biopsy procedure.
Objective
To investigate the potential application of rapid on-site evaluation (ROSE) during flexible bronchoscopy (FB) in the evaluation and diagnosis of lung lesions.
Patients and methods
Consecutive patients who underwent FB for the diagnosis of lung lesions between August 2022 and February 2023 were included in this retrospective study. 294 patients underwent FB with ROSE, while 304 patients underwent FB without ROSE. The final pathological results and the number of patients undergoing repeat biopsies were recorded in both groups. Specifically, we conducted separate statistical analysis for patients undergoing different biopsy methods, including the endobronchial biopsy (EBB), radial probe endobronchial ultrasound transbronchial lung biopsy with guide sheath (r-EBUS-GS-TBLB), and the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to study the detailed roles that ROSE plays under different biopsy methods.
Results
The adequacy rate of biopsy specimens from the non-ROSE group was significantly lower than that of the ROSE group (259/281 = 92.17 % vs. 263/268 = 98.13 %, p = 0.001). Meanwhile, fewer patients underwent repeat biopsies in the ROSE group compared to the non-ROSE group (2/294 = 0.68 % vs. 10/304 = 3.29 %, p = 0.023). For the ROSE group, the consistency between ROSE diagnoses and final pathological diagnoses was 94.40 % (κ = 0.886), with 95.58 % for benign diseases and 93.55 % for malignant diseases.
Conclusion
The utility of ROSE during FB increases the adequacy rate of biopsy specimens and thus decreases the need for repeat biopsies in patients with lung lesions to get a definite diagnosis. Moreover, the high consistency between ROSE diagnoses and final pathological diagnoses suggests that ROSE is a reliable tool for optimizing the diagnosis of lung lesions.
期刊介绍:
A peer-reviewed journal devoted to the publication of articles dealing with traditional morphologic studies using standard diagnostic techniques and stressing clinicopathological correlations and scientific observation of relevance to the daily practice of pathology. Special features include pathologic-radiologic correlations and pathologic-cytologic correlations.