EBUS ROSE-guided cytological evaluations of intrathoracic lesions. Assessments of the pathological material adequacy and the diagnostic efficacy

Several clinical groups consider cytological assessment under EBUS (Endobronchial Ultrasonography)-ROSE (Rapid Onsite Evaluation) as the golden standard for diagnosis and staging of intrathoracic lesions. On the other hand, some investigators proposed that EBUS-TBNA (Transbronchial Needle Aspiration) has considerably high false-negative rates for diagnosis. In this study, we analyzed our patient cohort (n = 152) with intrathoracic lesions and suspected malignancies evaluated by EBUS-ROSE. Our specific aims were: (i) to determine whether EBUS-ROSE could provide sufficient pathologic material for diagnosis and staging; (ii) to determine the fidelity of EBUS-ROSE-guided initial diagnoses in comparison to paraffin block diagnoses; (iii) to evaluate whether anatomical localization of sampled lymph nodes associate with material adequacy and final diagnoses.

NCSS (Number Cruncher Statistical System) 2020 Statistical Software (Utah, USA) was used for statistical analysis.

In EBUS-ROSE cytological assessment, material adequacy was determined in 50,7% (n = 77) of the cases. Considering the paraffin block pathology as the golden standart, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates of EBUS-ROSE were 90,2%, 93,1%, 94,8%, 87,1%, and 91,4%, respectively. There was no statistically significant difference between the final pathology and EBUS cytology results (p > .05) with a non-random Kappa agreement rate as 82.9%. There were differences in material adequacy and diagnoses according to the localization of sampled lymph node stations.

EBUS-ROSE is efficient to decide for the adequacy of the pathological specimen and provides diagnoses with reliable fidelity.