{"title":"快速现场评估对加快肺癌快速检查路径的影响。","authors":"Andrew Fowell, Kashif Khan","doi":"10.1111/cyt.13345","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>EBUS-TBNA is a method of acquiring tissue samples from intrathoracic lymph nodes and central intrathoracic tumours in patients suspected of having lung cancer. Rapid on-site evaluation (ROSE) denotes assessing tissue samples during EBUS (or bronchoscopy), providing instant feedback on sample adequacy and provisional cytomorphological diagnosis. Sector multidisciplinary team (MDT) discussion can then make informed treatment decisions, with confirmatory immunohistochemistry being finalised before provision of final treatment. Currently, impact of ROSE on length of time patients spend on the lung cancer diagnostic pathway remains unclear.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We retrospectively evaluated the impact of ROSE on the length of time between patients' EBUS/bronchoscopy procedures and discussion at sector MDT, referred to as time to treatment decision (TTD), at our institution. Additionally, we assessed impact of ROSE on number of passes (number of times nodes/masses were sampled) per procedure.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The mean TTD was 77.9% shorter (<i>p</i> = 0.001) with ROSE present than when absent. Patients who received ROSE spend 34.3% less time (<i>p</i> = 0.028) on lung cancer diagnostic pathway overall. There was a significant reduction in number of passes in non-malignant nodes with ROSE present (2.23) than when absent (3.14) (<i>p</i> < 0.001). With ROSE present there was a significantly greater number of passes at malignant sites (5.07) than non-malignant sites (2.23) (<i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>These findings support conclusions made in our institution's previous study, that utilisation of ROSE reduces TTD. ROSE also allows safe advancement through nodes with low suspicion of malignant involvement, focusing time on sampling nodes/masses of greater suspicion.</p>\n </section>\n </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 2","pages":"250-255"},"PeriodicalIF":1.2000,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of rapid on-site evaluation in expediting the fast investigative lung cancer pathway\",\"authors\":\"Andrew Fowell, Kashif Khan\",\"doi\":\"10.1111/cyt.13345\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>EBUS-TBNA is a method of acquiring tissue samples from intrathoracic lymph nodes and central intrathoracic tumours in patients suspected of having lung cancer. Rapid on-site evaluation (ROSE) denotes assessing tissue samples during EBUS (or bronchoscopy), providing instant feedback on sample adequacy and provisional cytomorphological diagnosis. Sector multidisciplinary team (MDT) discussion can then make informed treatment decisions, with confirmatory immunohistochemistry being finalised before provision of final treatment. Currently, impact of ROSE on length of time patients spend on the lung cancer diagnostic pathway remains unclear.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We retrospectively evaluated the impact of ROSE on the length of time between patients' EBUS/bronchoscopy procedures and discussion at sector MDT, referred to as time to treatment decision (TTD), at our institution. Additionally, we assessed impact of ROSE on number of passes (number of times nodes/masses were sampled) per procedure.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The mean TTD was 77.9% shorter (<i>p</i> = 0.001) with ROSE present than when absent. Patients who received ROSE spend 34.3% less time (<i>p</i> = 0.028) on lung cancer diagnostic pathway overall. There was a significant reduction in number of passes in non-malignant nodes with ROSE present (2.23) than when absent (3.14) (<i>p</i> < 0.001). With ROSE present there was a significantly greater number of passes at malignant sites (5.07) than non-malignant sites (2.23) (<i>p</i> < 0.001).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>These findings support conclusions made in our institution's previous study, that utilisation of ROSE reduces TTD. 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引用次数: 0
摘要
目的：EBUS-TBNA 是一种获取肺癌疑似患者胸腔内淋巴结和胸腔内中央肿瘤组织样本的方法。快速现场评估（ROSE）是指在 EBUS（或支气管镜）检查过程中对组织样本进行评估，即时反馈样本的充分性和临时细胞形态学诊断。部门多学科小组（MDT）讨论后可做出明智的治疗决定，并在提供最终治疗前完成免疫组化确诊。目前，ROSE 对患者在肺癌诊断过程中所花费时间的影响仍不明确：我们回顾性地评估了 ROSE 对本机构患者从 EBUS/支气管镜检查到部门 MDT 讨论之间的时间长度（称为治疗决策时间（TTD））的影响。此外，我们还评估了 ROSE 对每次手术通过次数（结节/肿块取样次数）的影响：结果：有 ROSE 时的平均 TTD 比没有 ROSE 时短 77.9% (p = 0.001)。接受 ROSE 的患者在肺癌诊断路径上花费的时间总体减少了 34.3% (p = 0.028)。存在 ROSE 时，非恶性结节的检查次数（2.23 次）比不存在 ROSE 时（3.14 次）明显减少（p 结论：ROSE 可使肺癌患者在肺癌诊断路径上减少 34.3% 的时间（p = 0.028）：这些研究结果支持本机构之前的研究结论，即使用 ROSE 可减少 TTD。ROSE 还能安全推进恶性程度怀疑较低的结节，将时间集中在取样怀疑较高的结节/肿块上。
Impact of rapid on-site evaluation in expediting the fast investigative lung cancer pathway
Objective
EBUS-TBNA is a method of acquiring tissue samples from intrathoracic lymph nodes and central intrathoracic tumours in patients suspected of having lung cancer. Rapid on-site evaluation (ROSE) denotes assessing tissue samples during EBUS (or bronchoscopy), providing instant feedback on sample adequacy and provisional cytomorphological diagnosis. Sector multidisciplinary team (MDT) discussion can then make informed treatment decisions, with confirmatory immunohistochemistry being finalised before provision of final treatment. Currently, impact of ROSE on length of time patients spend on the lung cancer diagnostic pathway remains unclear.
Methods
We retrospectively evaluated the impact of ROSE on the length of time between patients' EBUS/bronchoscopy procedures and discussion at sector MDT, referred to as time to treatment decision (TTD), at our institution. Additionally, we assessed impact of ROSE on number of passes (number of times nodes/masses were sampled) per procedure.
Results
The mean TTD was 77.9% shorter (p = 0.001) with ROSE present than when absent. Patients who received ROSE spend 34.3% less time (p = 0.028) on lung cancer diagnostic pathway overall. There was a significant reduction in number of passes in non-malignant nodes with ROSE present (2.23) than when absent (3.14) (p < 0.001). With ROSE present there was a significantly greater number of passes at malignant sites (5.07) than non-malignant sites (2.23) (p < 0.001).
Conclusions
These findings support conclusions made in our institution's previous study, that utilisation of ROSE reduces TTD. ROSE also allows safe advancement through nodes with low suspicion of malignant involvement, focusing time on sampling nodes/masses of greater suspicion.
期刊介绍：
The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy.
Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.
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