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Author Spotlight: Advancing Pathogen Detection and Disease Assessment in Real-Time Using M-ROSE
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Sample adequacy in bronchoscopic ROSE: comparison between laboratory specialist and pathologist.

Gergő Szűcs1, Judit Pápay2, Eszter Regős2

  • 1Department of Pulmonology, Semmelweis University, Budapest, Hungary.

Pathology Oncology Research : POR
|February 19, 2026
PubMed
Summary
This summary is machine-generated.

Clinical biochemists can effectively perform rapid on-site evaluation (ROSE) of bronchoscopy samples, showing high agreement with cytopathologists. This approach offers a viable solution for resource limitations in pathology services.

Keywords:
EBUSROSEbronchoscopylaboratory specialistpathologist

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Area of Science:

  • Pulmonology
  • Cytopathology
  • Clinical Biochemistry

Background:

  • Rapid on-site evaluation (ROSE) during bronchoscopy is crucial for assessing sample adequacy and enabling timely diagnosis.
  • Traditionally, cytopathologists perform ROSE, but this is not always feasible due to resource constraints.
  • This study explores the role of a clinical biochemist in performing ROSE at a university institution.

Purpose of the Study:

  • To compare the effectiveness of ROSE evaluations conducted by a laboratory specialist (clinical biochemist) versus a cytopathologist.
  • To assess the agreement and diagnostic performance of ROSE smears evaluated by both professionals.
  • To determine if a laboratory specialist can serve as a viable alternative for ROSE.

Main Methods:

  • Retrospective analysis of 78 lymph node samples obtained via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and transbronchial needle aspiration (TBNA).
  • Smears were evaluated for adequacy by a clinical biochemist (laboratory specialist) and a pathologist team simultaneously.
  • Agreement was measured using Cohen's kappa and Gwet's AC1 statistics.

Main Results:

  • A high agreement rate of 92.3% was observed between the laboratory specialist and the pathologist team.
  • Cohen's kappa value was 0.71 (strong agreement) and Gwet's AC1 was 0.90 (almost perfect agreement).
  • Both methods demonstrated excellent diagnostic performance.

Conclusions:

  • Rapid on-site evaluation performed by a laboratory specialist is a suitable and reliable alternative to evaluation by a cytopathologist.
  • This approach can help alleviate shortages of interventional pulmonologists and cytopathologists.
  • Utilizing clinical biochemists for ROSE can improve the efficiency and accessibility of diagnostic procedures during bronchoscopy.