|本期目录/Table of Contents|

[1]陈心怡,张扬,金宁,等.支气管镜检查联合快速现场细胞学诊断的应用[J].中华肺部疾病杂志,2022,(04):498-501.[doi:10.3877/cma.j.issn.1674-6902.2022.04.010]
 Chen Xinyi,Zhang Yang,Jin Ning,et al.Application of bronchoscopy combined with rapid on-site cytologic evaluation[J].,2022,(04):498-501.[doi:10.3877/cma.j.issn.1674-6902.2022.04.010]
点击复制

支气管镜检查联合快速现场细胞学诊断的应用(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2022年04期
页码:
498-501
栏目:
论著
出版日期:
2022-08-20

文章信息/Info

Title:
Application of bronchoscopy combined with rapid on-site cytologic evaluation
作者:
陈心怡1张扬1金宁2冯旰珠1沈红1
210011 江苏,南京医科大学第二附属医院呼吸与危重症医学科1、病理科2
Author(s):
Chen Xinyi1 Zhang Yang1 Jin Ning2 Feng Ganzhu1 Shen Hong1.
1Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China; 2Department of Pathology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
关键词:
快速现场细胞学评估 支气管镜检查 细胞病理学
Keywords:
Rapid on-site cytologic evaluation Bronchoscopy Cytopathology
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2022.04.010
摘要:
目的 分析支气管镜检查联合快速现场细胞学评估(C-ROSE)的应用。方法 选择我院行支气管镜检查患者240例,分为C-ROSE组79例,非C-ROSE组161例,分析两组的诊断率。结果 与金标准相比,肺科医师对样本充分性的判读、良恶性病变的鉴别及肺癌诊断高度一致,Kappa值分别为0.904、0.970、0.794。C-ROSE联合支气管镜检查的诊断效能良好,敏感性为100%,特异性为97.83%,诊断准确率98.61%,阳性预测值96.30%,阴性预测值为100%。C-ROSE组恶性疾病诊断率明显高于非C-ROSE组(92.86% vs. 73.21%,P<0.05),两组的总诊断率和良性疾病诊断率差异无统计学意义。C-ROSE组恶性疾病的二次检查率明显低于非C-ROSE组(7.14% vs. 26.79%,P<0.05)。结论 经系统培训的肺科医师能掌握C-ROSE技术,在支气管镜检查中能判读样本充分性,区分良恶性病变,提高诊断率、减少二次检查率,具有临床意义。
Abstract:
Objective To analyze the application of bronchoscopy combined with rapid on-site cytologic evaluation(C-ROSE). Methods Retrospective study of 240 cases who were performed with bronchoscopy at the Second Affiliated Hospital of Nanjing Medical University in 2020. There were 79 cases in C-Rose group and 161 cases in non-C-Rose group. The diagnostic yield and the secondary examination rates between C-ROSE group and non C-ROSE group were also compared. Results Compared with the gold standard, the pulmonologist's interpretation of sample adequacy, identification of benign and malignant lesions, and diagnosis of lung cancer were all highly consistent, the Kappa value were 0.904,0.970,0.794 respectively. When C-ROSE was applied to bronchoscopy, the diagnostic efficacy was pretty good, the sensitivity was 100%, the specificity was 97.83%, the diagnostic accuracy was 98.61%, the positive predictive value was 96.30% and the negative predictive value was 100%. The diagnostic yield of malignant disease was statistically higher in C-ROSE group than that in non C-ROSE group(92.86% vs. 73.21%, P<0.05). There was no statistical difference between the two groups in the total diagnostic yield and the benign disease diagnostic yield. The secondary examination rate of malignant disease was statistically lower than that in non C-ROSE group(7.14% vs. 26.79%, P<0.05). Conclusion Pulmonologists can master C-ROSE technique after short time of systematic training. A trained pulmonologist can reliably carry out C-ROSE to interpret sample adequacy, distinguish between benign and malignant lesions, help improve the diagnostic yield and reduce the secondary examination rate. C-ROSE technique is effective-cost, it worthy of wide use in most hospitals.

参考文献/References:

1 Wohlschläger J, Darwiche K, Ting S, et al. Rapid onsite evaluation(ROSE)in cytological diagnostics of pulmonary and mediastinal diseases[J]. Pathologe, 2012, 33(4): 308315.
2 van Riet PA, Cahen DL, Poley J-W, et al. Mapping international practice patterns in EUS-guided tissue sampling: outcome of a global survey[J]. Endosc Int Open, 2016, 4(3): E360-E370.
3 黄浩昌, 李燕燕, 李新军, 等. 远程实时快速评价在经支气管镜肺活检术中的应用[J]. 中华结核和呼吸杂志, 2021, 44(3): 270-271.
4 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[J]. Chest, 2014, 145(1): 60-65.
5 Natali F, Cancellieri A, Tinelli C, et al. A trained pulmonologist can reliably assess endosonography-derived lymph node samples during rapid on-site evaluation[J]. Respiration, 2019, 97(6): 540-547.
6 Umeda Y, Otsuka M, Nishikiori H, et al. Feasibility of rapid on-site cytological evaluation of lung cancer by a trained pulmonologist during bronchoscopy examination[J]. Cytopathology, 2019, 30(6): 628-633.
7 Meena N, Jeffus S, Massol N, et al. Rapid on site evaluation: A comparison of cytopathologist and pulmonologist performance[J]. Cancer Cytopathol, 2016, 124(4): 279-284.
8 Natali F, Cancellieri A, Giunchi F, et al. Interobserver agreement between pathologist, pulmonologist and molecular pathologist to estimate the tumour burden in rapid on-site evaluation smears from endosonography and guided bronchoscopy[J]. Cytopathology, 2020, 31(4): 303-3309.
9 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[J]. Diagn Cytopathol, 1999, 21(1): 61-69.
10 Wang HS, Wei N, Tang YJ, et al. The utility of rapid on-site evaluation during bronchoscopic biopsy: A 2-Year respiratory endoscopy central experience[J]. Biomed Res Int, 2019, 2019: 5049248.
11 Botticella MA, Summa SD, Cisternino L, et al. The role of rapid on site evaluation on touch imprint cytology and brushing during conventional bronchoscopy[J]. Diagnostic Cytopathol, 2021, 49(7): 832-837.
12 黄秋博, MARCIANO G, 胡早秀, 等. 现场快速评估在纤维支气管镜活检中的应用研究[J]. 云南医药, 2018, 39(2): 97-100.
13 Thiryayi SA, Rana DN, Narine N, et al. Establishment of an endobronchial ultrasound-guided transbronchial fine needle aspiration service with rapid on-site evaluation: 2 years experience of a single UK centre[J]. Cytopathology, 2016, 27(5): 335-343.
14 Mondoni M, Carlucci P, Marco FD, et al. Rapid On-Site Evaluation improves needle aspiration sensitivity in the diagnosis of central lung cancers: a randomized trial[J]. Respiration, 2013, 86(1): 52-58.
15 Madan NK, Madan K, Jain D, et al. Utility of conventional transbronchial needle aspiration with rapid on-site evaluation(c-TBNA-ROSE)at a tertiary care center with endobronchial ultrasound(EBUS)facility[J]. J Cytol, 2016, 33(1): 22-26.
16 Guarino C, Mollica M, Cesaro C, et al. Diagnostic yield of rapid on-site evaluation transbronchial needle aspiration versus conventional transbronchial needle aspiration: a single center experience[J]. Monaldi Arch Chest Dis, 2020, 90(1): 73-77.
17 Trisolini R, Cancellieri A, Tinelli C, et al. Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy: a randomized trial[J]. Chest, 2011, 139(2): 395-401.
18 李凯述, 刘明涛, 姜淑娟, 等. 经支气管镜针吸活检联合现场细胞学对肺癌诊断的临床价值[J]. 中国肺癌杂志, 2014(3): 215-220.
19 Guo HB, Liu SJ, 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[J]. Cancer Lett, 2016, 371(2): 182-186.
20 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[J]. 中国肺癌杂志, 2018, 21(11): 833-840.
21 Mondoni M, Sotgiu G, Bonifazi M, et al. Transbronchial needle aspiration in peripheral pulmonary lesions: a systematic review and meta-analysis[J]. Eur Respir J, 2016, 48(1): 196-204.
22 Wang J, Zhao YP, Chen QQ, et al. Diagnostic value of rapid on-site evaluation during transbronchial biopsy for peripheral lung cancer[J]. Jpn J Clin Oncol, 2019, 49(6): 501-505.
23 Xu CH, Wang W, Yuan Q, et al. Rapid on-site evaluation during radial endobronchial ultrasound-guided transbronchial lung biopsy for the diagnosis of peripheral pulmonary lesions[J]. Technol Cancer Res Treat, 2020, 19: 1533033820947482.
24 Wang HS, Ren T, Wang X, et al. Rapid on-site evaluation of touch imprints of biopsies improves the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy: a retrospective study[J]. Jpn J Clin Oncol, 2021, 51(4): 622-629.
25 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]. J Thorac Dis, 2015, 7(Suppl 4): S418-S425.
26 Karnak D, Cileda A, Ceyhan K, et al. Rapid on-site evaluation and low registration error enhance the success of electromagnetic navigation bronchoscopy[J]. Ann Thorac Med, 2013, 8(1): 28-32.
27 Gex G, Pralong JA, Combescure C, et al. Diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules: a systematic review and meta-analysis[J]. Respiration, 2014, 87(2):165-176.
28 房宇坤, 李 玉, 王 剑, 等. 微生物学快速现场评估在支气管镜下诊断肺部感染的价值[J]. 中国当代医药, 2020, 27(14): 4-7, 29.
29 Chen X, Wan B, Xu YY, et al. Efficacy of rapid on-site evaluation for diagnosing pulmonary lesions and mediastinal lymph nodes: a systematic review and meta-analysis[J]. Transl Lung Cancer Res, 2019, 8(6): 1029-1044.
30 Lin CK, Jan IS, Yu KL, et al. Rapid on-site cytologic evaluation by pulmonologist improved diagnostic accuracy of endobronchial ultrasound-guided transbronchial biopsy[J]. J Formos Med Assoc, 2020, 119(11): 1684-1692.
31 冯 靖, 陈宝元, 吴 琦. 应重视介入呼吸病学的快速现场评价[J]. 天津医药, 2014,(3): 193-196.
32 Yuan ML, Wang YF, Yin W, et al. Efficacy of rapid on-site cytological evaluation(ROSE)by a pulmonologist in determining specimen adequacy and diagnostic accuracy in interventional diagnosis of lung lesions[J]. J Int Med Res, 2021, 49(2): 1-10.

备注/Memo

备注/Memo:
基金项目: 南京市医学科技发展资金(YKK16226)
通信作者: 沈 红, Email: shenhong603@163.com
更新日期/Last Update: 2022-08-20