Abstract
Background: Endobronchial ultrasound (EBUS)-guided fine needle aspiration (FNA) is performed to diagnose and stage lung cancer. Multiple studies have described the value of Rapid On-Site Evaluation (ROSE), but often the emphasis is upon diagnosis than adequacy for molecular testing (MT). The aim was to identify variable(s), especially cytology-related, that can improve MT. Methods: A search for EBUS-FNAs with ROSE was conducted for lung adenocarcinomas or when this diagnosis could not be excluded. All such cases underwent reflex MT on cell blocks. The impact of cytology-related variables [i.e., number of pass(es), dedicated pass(es) directly into media, cytotechnologist (CT), laboratory technician (LT) and triage with 1 or >1 cytologist] was evaluated. The latter category was divided into Group A [ROSE, triage and slide preparation by cytopathologist (CP) and CT at start of the procedure] and Group B (ROSE only by CT or by CT/CP after start of procedure; triage and slide preparation by CT or clinical staff). The impact of all these variables on MT was assessed. Results: A total of 100 cases were identified, and 79 had sufficient tissue for MT. Of all variables evaluated, MT was positively affected by performing a direct dedicated pass (P = 0.013) and ROSE by Group A (P = 0.033). Conclusions: ROSE with appropriate triage, including performing a dedicated pass and proper slide preparation, improves MT, and this is enhanced by having >1 cytologist at the start of the procedure. In the era of personalized medicine, “adequate” should denote sufficient tissue for diagnosis and MT.
Original language | English (US) |
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Pages (from-to) | 122-130 |
Number of pages | 9 |
Journal | Diagnostic Cytopathology |
Volume | 46 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2018 |
Externally published | Yes |
Keywords
- EBUS FNA
- ROSE
- endobronchial ultrasound fine needle aspiration
- lung
- molecular testing
- rapid on-site evaluation
- triage and adequacy
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Histology