Efficacy of rapid on-site cytological evaluation (ROSE) by a pulmonologist

in determining specimen adequacy and diagnostic accuracy in interventional

diagnosis of lung lesions
Mingli Yuan1, Yafei Wang2, Wen Yin3, Yang Xiao4, Manman Hu5, and Yi Hu6
Department of Respiratory Medicine, Central Hospital of Wuhan, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
Yi Hu, Department of Respiratory Medicine, Central Hospital of Wuhan, Tongji Medical
College, Huazhong University of Science and Technology, 26 Shengli Street, Jiang’an,
Wuhan 430014, China.
moc.latipsohxz@iyuh

ABSTRAK

Objective
To evaluate the efficacy of rapid on-site cytological evaluation (ROSE) in determining
specimen adequacy and diagnostic accuracy in the interventional diagnosis of lung lesions.

Methods
This retrospective study included 127 consecutive cases of lung lesions, which were sampled
by bronchoscopy or transthoracic fine needle aspiration, and diagnosed on ROSE followed by
histopathology. ROSE was performed by a trained pulmonologist and the diagnosis of ROSE
was compared with the final diagnosis.

Results
The sensitivity of ROSE in determining adequacy of specimens was 97.5% and specificity in
determining inadequacy was 85.7%. The diagnostic efficacy of ROSE for assessing
malignancy (sensitivity of 94.5% and specificity of 100%) and non-malignancy (sensitivity of
97.8% and specificity of 100%) was excellent. The sensitivity of ROSE for diagnosing small
cell carcinoma (100%) was highest, followed by adenocarcinoma (89.2%) and squamous cell
carcinoma (75.0%). Performance of ROSE by a trained pulmonologist also determined
tuberculosis with a high diagnostic sensitivity (83.3%) and specificity (100%).

Conclusions
A trained pulmonologist can reliably carry out ROSE to ensure the adequacy of the sample,
distinguish between malignancy and non-malignancy, and make a preliminary diagnosis in a
large number of cases.
Keywords: Cytology, lung lesion, rapid on-site evaluation, diagnostic accuracy, interventional
pulmonology, malignancy
 ABSTRAK

Objektif

Untuk mengevaluasi efektifitas rapid on-site cytological evaluation (ROSE) dalam

menentukan kecukupan spesimen dan akurasi diagnostik dalam diagnosis intervensi lesi paru-

paru.

Metode

Studi retrospektif ini mencakup 127 kasus lesi paru berturut-turut, yang diambil sampelnya

dengan bronkoskopi atau aspirasi jarum halus transthoracic, dan didiagnosis dengan ROSE

diikuti dengan histopatologi. ROSE dilakukan oleh ahli paru terlatih dan diagnosis ROSE

dibandingkan dengan diagnosis akhir.

Hasil

Sensitivitas ROSE dalam menentukan kecukupan spesimen adalah 97,5% dan spesifisitas

dalam menentukan ketidakcukupan adalah 85,7%. Kemanjuran diagnostik ROSE untuk

menilai keganasan (sensitivitas 94,5% dan spesifisitas 100%) dan non-keganasan (sensitivitas

97,8% dan spesifisitas 100%) sangat baik. Sensitivitas ROSE untuk mendiagnosis karsinoma

sel kecil (100%) paling tinggi, diikuti oleh adenokarsinoma (89,2%) dan karsinoma sel

skuamosa (75,0%). Kinerja ROSE oleh ahli paru terlatih juga menentukan tuberkulosis dengan

sensitivitas diagnostik yang tinggi (83,3%) dan spesifisitas (100%).

Kesimpulan

Seorang ahli paru terlatih dapat dengan andal melakukan ROSE untuk memastikan kecukupan

sampel, membedakan antara keganasan dan non-keganasan, dan membuat diagnosis awal pada

sejumlah besar kasus.

Kata kunci: Sitologi, lesi paru, evaluasi cepat di tempat, akurasi diagnostik, pulmonologi

intervensi, keganasan