https://scholars.lib.ntu.edu.tw/handle/123456789/510361
標題: | Rapid on-site cytologic evaluation by pulmonologist improved diagnostic accuracy of endobronchial ultrasound-guided transbronchial biopsy | 作者: | CHING-KAI LIN I-SHIOW JAN KAI-LUN YU LIH-YU CHANG Fan H.-J. Wen Y.-F. CHAO-CHI HO |
公開日期: | 2020 | 出版社: | Elsevier B.V. | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Rapid on-site cytologic evaluation (ROSE) has been shown to improve the diagnostic accuracy of endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB). However, ROSE by a cytopathologist or cytotechnologist is not always available during the procedure. The purposes of this study were to verify that a pulmonologist, after receiving training in cytology, could accurately assess an EBUS-TBB specimen on-site, and to evaluate the contribution of ROSE to EBUS-TBB. Methods: A retrospective chart review of patients who underwent EBUS-TBB for diagnosis of peripheral pulmonary lesions (PPLs) from January 2014 to June 2017 was performed. PPLs without a malignant diagnosis were excluded. The ROSE result determined by a pulmonologist was compared to the formal imprint cytologic report and pathologic report. The diagnostic accuracy of EBUS-TBB was also compared between those with and without ROSE. Results: Two hundred ninety-three patients who underwent 336 EBUS-TBB procedures for PPL diagnosis and were found to have proven malignancy were enrolled. Eighty-six procedures were performed with ROSE. With the formal imprint cytologic diagnosis as the standard, ROSE had 96.9% sensitivity, 68.2% specificity, 89.9% positive predictive value (PPV), 88.2% negative predictive value (NPV), and 89.5% diagnostic accuracy. With the formal pathologic result as the standard, ROSE had 88.2% sensitivity, 80% specificity, 97.1% PPV, 47.1% NPV, and 87.2% diagnostic accuracy, respectively. The diagnostic accuracy was significantly higher when ROSE was performed during EBUS-TBB (88.4% vs 68.0%, P < 0.001). Conclusion: A trained pulmonologist can interpret adequately cytologic smears on-site and effectively improve the accuracy of EBUS-TBB in the diagnosis of PPLs. ? 2020 Formosan Medical Association |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85077913695&doi=10.1016%2fj.jfma.2020.01.001&partnerID=40&md5=320f2db6d517970ca1e28554246ee05c https://scholars.lib.ntu.edu.tw/handle/123456789/510361 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2020.01.001 | SDG/關鍵字: | bronchodilating agent; fentanyl; lidocaine; midazolam; adult; aged; Article; bronchospasm; cancer cytodiagnosis; cancer patient; conscious sedation; controlled study; cytodiagnosis; diagnostic accuracy; diagnostic test accuracy study; diagnostic value; disease severity; endobronchial ultrasonography; female; human; human tissue; hypoxia; interventional ultrasonography; local anesthesia; lung cancer; major clinical study; male; malignant neoplasm; medical record review; oxygen therapy; peripheral lung lesion; pleura effusion; pneumothorax; predictive value; pulmonologist; rapid on site cytologic evaluation; retrospective study; sensitivity and specificity; thorax drainage; transbronchial biopsy; tumor volume; biopsy; bronchoscopy; diagnostic imaging; interventional ultrasonography; lung tumor; Biopsy; Bronchoscopy; Humans; Lung Neoplasms; Pulmonologists; Retrospective Studies; Ultrasonography, Interventional |
顯示於: | 醫學系 |
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