Abstract：
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.
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.
摘要：
目的：EBUS-TBNA是一种从疑似肺癌患者的胸内淋巴结和中央胸内肿瘤中获取组织样本的方法。快速现场评估（ROSE）表示在EBUS（或支气管镜检查）期间评估组织样本，提供样本充足性和临时细胞形态学诊断的即时反馈。部门多学科团队（MDT）讨论可以做出明智的治疗决定，在提供最终治疗之前完成验证性免疫组织化学。目前,ROSE对患者在肺癌诊断通路上花费的时间长度的影响尚不清楚.
方法：我们回顾性评估了ROSE对患者EBUS/支气管镜检查与部门MDT讨论之间时间长度的影响，称为治疗决策时间(TTD)，在我们的机构。此外,我们评估了ROSE对每个手术的通过次数(节点/肿块采样次数)的影响.
结果：存在ROSE时比不存在时平均TTD短77.9%（p=0.001）。接受ROSE的患者在肺癌诊断途径上花费的时间总体上减少了34.3％（p=0.028）。存在ROSE（2.23）的非恶性淋巴结的通过次数显着减少，而不存在ROSE（3.14）（p<0.001）。在存在ROSE的情况下，恶性部位（5.07）的通过次数明显多于非恶性部位（2.23）（p<0.001）。
结论：这些发现支持我们机构先前研究中得出的结论，ROSE的使用降低了TTD。ROSE还可以通过淋巴结安全推进，怀疑恶性程度低，将时间集中在更怀疑的采样节点/质量上。
方法：我们回顾性评估了ROSE对患者EBUS/支气管镜检查与部门MDT讨论之间时间长度的影响，称为治疗决策时间(TTD)，在我们的机构。此外,我们评估了ROSE对每个手术的通过次数(节点/肿块采样次数)的影响.
结果：存在ROSE时比不存在时平均TTD短77.9%（p=0.001）。接受ROSE的患者在肺癌诊断途径上花费的时间总体上减少了34.3％（p=0.028）。存在ROSE（2.23）的非恶性淋巴结的通过次数显着减少，而不存在ROSE（3.14）（p<0.001）。在存在ROSE的情况下，恶性部位（5.07）的通过次数明显多于非恶性部位（2.23）（p<0.001）。
结论：这些发现支持我们机构先前研究中得出的结论，ROSE的使用降低了TTD。ROSE还可以通过淋巴结安全推进，怀疑恶性程度低，将时间集中在更怀疑的采样节点/质量上。
