Rapid on-site evaluation of touch imprints of biopsies improves the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy: a retrospective study

Abstract

Objective Rapid on-site evaluation has long been used for transbronchial needle aspiration or fine-needle aspiration to evaluate the adequacy of biopsy materials for the diagnosis of peripheral lung lesions. However, research on rapid on-site evaluation combined with transbronchial forceps biopsy in the diagnosis of lung carcinoma is rarely reported. Therefore, we aimed to investigate the value of rapid on-site evaluation during transbronchial forceps biopsy for endoscopically visible (tumor, infiltrative and necrotic) or nonvisible (compressive, nonspecific and normal) malignancy. Methods A retrospective analysis was performed between January 2015 and January 2019 in Taihe Hospital with 1216 lung cancer patients who underwent bronchoscopy procedures, and these patients were allocated into the rapid on-site evaluation group and non-rapid on-site evaluation group, depending on the timing of the procedure. According to endoscopic features, bronchoscopic appearance was described as endoscopically visible malignancy (tumor, infiltrative and necrotic) and endoscopically nonvisible malignancy (compressive, nonspecific and normal). The diagnostic yield was compared, and the concordance between the rapid on-site evaluation results and the final histology was analyzed. Results There was a statistically significant difference in the diagnostic yield between the rapid on-site evaluation and non-rapid on-site evaluation groups for endoscopically nonvisible malignancy (74.3% vs. 51.7%, P < 0.05). However, we found no significant improvement in terms of diagnostic yield for endoscopically visible malignancy (95.2% vs. 91.2%, P > 0.05). The rapid on-site evaluation results showed high-level concordance with histology in the diagnosis of squamous cell carcinoma, adenocarcinoma and small cell carcinoma, with kappa values of 0.749 (P < 0.05), 0.728 (P < 0.05) and 0.940 (P < 0.05), respectively. Conclusions The findings demonstrated that the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy (compressive, nonspecific and normal) was significantly improved when rapid on-site evaluation was implemented. In addition, the rapid on-site evaluation results had high-level concordance with the final histological diagnosis.

Value of rapid on‐site evaluation combined with interventional pulmonology techniques in the diagnosis of pulmonary cryptococcosis

“…The ROSE result was consistent with the histopathological results for pulmonary cancer and peripheral pulmonary lesion doagnosis. 8 , 17 , 18 A high coincidence rate between ROSE and histopathological findings, with a kappa value of 0.574, was also observed; the positive diagnostic rate of PC did not change significantly. Therefore, ROSE has good consistency with histopathology for PC diagnosis and exhibits a certain level of accuracy and timeliness.…”

Clinical utility of rapid on-site evaluation of brush cytology during bronchoscopy using endobronchial ultrasound with a guide sheath

“…Rapid on-site evaluation (ROSE) is used to con rm tumor cells in cytological specimens, and its utility in bronchoscopy has been studied using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which suggested that ROSE improves the diagnostic yield of EBUS-TBNA and decreases the number of biopsies required [20][21][22]. The same has been reported for bronchoscopy of PPL [23][24][25][26][27][28].…”

“…When performing ROSE during bronchoscopy using EBUS-GS for PPL, two types of cytology specimens must be evaluated: imprint cytology of forceps biopsy and brush cytology. There are many reports on ROSE of imprint cytology of forceps biopsy [23][24][25][26], but there are few reports on brush cytology [27,28].…”

Rapid on-site evaluation of touch imprints of medical thoracoscopy biopsy tissue for the management of pleural disease

“…Rapid on-site evaluation (ROSE) is a cytomorphological diagnostic procedure that assesses the adequacy and accuracy of the material obtained during bronchoscopy within a few minutes in or near the bronchoscopy suite (on-site) using rapid staining (e.g., Diff-Quik or Hemacolor) of touch imprints of biopsies (5). ROSE has been reported to improve the diagnostic yield of transbronchial biopsy for endoscopically non-visible malignancy during transbronchial forceps biopsy (TFB) (6), to obtain high diagnostic performance and an acceptable rate of complications during computed tomography (CT)-guided fine-needle aspiration (FNA) for pulmonary lesions (7,8), to significantly improve diagnostic yields (9), and to lower the additional number of biopsies (10)(11)(12) during transbronchial needle aspiration (TBNA).…”