336 Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Without Rapid On-site Evaluation Performed: A Retrospective Study with Cytologic-Histologic Correlation Comparing Main Campus Versus Regional Hospitals
Recommended Citation
Ozcan GG, Vitale A, Tawil T, Gagnon L, Zhang Z, Yuan L. 336 Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Without Rapid On-site Evaluation Performed: A Retrospective Study with Cytologic-Histologic Correlation Comparing Main Campus Versus Regional Hospitals. Lab Invest 2025; 105(3).
Document Type
Conference Proceeding
Publication Date
3-24-2025
Publication Title
Lab Invest
Keywords
programmed death 1 ligand 1, adolescent, adult, aged, conference abstract, controlled study, cost benefit analysis, cytology, diagnosis, diagnostic test accuracy study, diagnostic value, endobronchial ultrasonography, female, fine needle aspiration biopsy, gold standard, histology, human, human tissue, lung hilus, lung nodule, major clinical study, male, mediastinum mass, minimally invasive procedure, rapid on-site evaluation, retrospective study, sensitivity and specificity, tertiary care center, transbronchial aspiration, vagina smear kit
Abstract
Disclosures: Gamze Gokturk Ozcan: None; Alyssa Vitale: None; Tala Tawil: None; Lauren Gagnon: None; Ziying Zhang: None; Lisi Yuan: None Background: Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a safe and minimally invasive procedure for evaluating lung nodules and lymph nodes. The reported sensitivity and specificity of EBUS-TBNA with rapid on-site evaluation (ROSE) are variable at 85-90% and 90-95%, respectively. We employed a method for performing EBUS without ROSE at our institution with staffing and cost benefit. We're a tertiary care center with a main campus and peripheral sites. The aim of this study is to determine the diagnostic value of our EBUS-TBNA without ROSE method and access the effectiveness of this method at the peripheral sites. Design: Cells were collected by pulmonologists; all passes were put in Saccomanno preserve and sent to Cytology lab. The cells were then drained through tissue bag to collect tissue fragments for making cell blocks. The liquid portion was used for making ThinPrep slide. All consecutive EBUS cases, including FNA of the lung nodules, hilar/mediastinal masses, and lymph nodes between 5/2022-4/2023 at our institution (main campus and peripheral sites) were included. Pathological findings and clinical information were collected from pathology archives and medical records, respectively. Results: In the study period, 1805 EBUS cases from 676 patients were identified at main campus site, including 364 lung/ mediastinal masses and 1441 lymph nodes. Cytology diagnosis were non-diagnostic (ND) in 203 (11%), benign (1124, 62%), atypical (65, 3.6%), suspicious (12, 0.7%), and positive (399, 22%). When histology was taken as the gold standard, the sensitivity and specificity of our method (EBUS without ROSE) were 90.8% and 97%, respectively. Molecular and PD-L1 were ordered on 72 and 71 positive cyto cases, respectively, all adequate. At peripheral sites, 210 EBUS cases from 96 patients were identified including 70 lung/ hilar masses and 140 lymph nodes. Cytology diagnosis were ND in 47 (22%), benign (99, 47%), atypical (8, 3.8%), and positive (56, 27%). The sensitivity and specificity for EBUS-TBNA at our peripheral sites were 86.4% and 97.9%, respectively. Molecular testing were ordered on 4 positive cyto cases (3 adequate); PDL-1 were ordered on 5 positive cyto cases (all adequate). [Formula presented] Conclusions: EBUS without ROSE method at our institution provided sufficient adequacy for ancillary testing and rendering diagnosis, with excellent sensitivity and specificity even at the peripheral sites. This method also provided excellent tumor cellularity for molecular and PDL-1 testing.
Volume
105
Issue
3
