Rapid on-site evaluation combined with endobronchial ultrasound for the diagnosis of pulmonary/mediastinal lesions: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TANG Zhengneng ¹ , GE Jie ² ,  GONG Liming ¹ , WANG Dongkun ¹ , QIU Hao ¹

1. Department of Thoracic and Cardiovascular Surgery, The First People’s Hospital of Kunming City, Kunming, 650034, P. R. China;
2. The First Affiliated Hospital of Kunming Medical University, Kunming, 650532, P. R. China;

Corresponding?author：

GONG Liming, Email: Kmliza@126.com

Keywords：

Rapid on-site evaluation; endobronchial ultrasound; needle biopsy; pulmonary lesions; mediastinal lesions; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202211012

Video：

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Objective To systematically review the value of rapid on-site evaluation (ROSE) for diagnosing pulmonary and mediastinal lesions with endobronchial ultrasound (EBUS). Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases were searched by computer to collect the studies of ROSE and EBUS in the diagnosis of pulmonary and mediastinal lesions from inception to August 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Meta-analysis was implemented by RevMan 5.4 and Stata 12.0 software. Results A total of 15 studies (9 retrospective studies and 6 prospective studies) with 3 577 patients were included. The meta-analysis results of main outcomes showed that the adequacy of the sample (RD=0.10, 95%CI 0.05 to 0.15, P<0.000 1), overall diagnosis rate (RD=0.07, 95%CI 0.04 to 0.10, P<0.000 1) and the diagnosis rate of the malignant lesion (RD=0.06, 95%CI 0.02 to 0.09, P=0.004) of the ROSE combined with EBUS group were significantly higher than those of the EBUS group. Subgroup analysis showed that the diagnosis rates of pulmonary lesions (RD=0.12, 95%CI 0.08 to 0.17, P<0.000 01) and mediastinal lesions (RD=0.06, 95%CI 0.01 to 0.12, P=0.02) in the ROSE group was significantly higher than those in the EBUS group. The overall diagnosis rate and malignant diagnosis rate of ROSE combined with EBUS were 90% and 92%. The meta-analysis results of secondary outcomes showed that the number of lesions punctures (MD=–1.16, 95%CI –1.89 to –0.43, P=0.002) in the ROSE combined with EBUS group were significantly less than that in the EBUS group; there was no statistical difference in operation time (MD=0.09, 95%CI –5.22 to 5.39, P=0.97) or incidence of complications (RD=–0.06, 95%CI –0.13 to 0.01, P=0.1) between the two groups. Conclusion ROSE can improve the diagnostic efficiency of EBUS in pulmonary and mediastinal lesions, and has the value of the clinical application.

Citation： TANG Zhengneng, GE Jie, GONG Liming, WANG Dongkun, QIU Hao. Rapid on-site evaluation combined with endobronchial ultrasound for the diagnosis of pulmonary/mediastinal lesions: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(7): 1043-1049. doi: 10.7507/1007-4848.202211012 Copy

1.	梁天齊, 張月強. 低劑量螺旋CT對篩查早期肺癌的臨床價值及準確性分析. 現代醫用影像學, 2022, 31(6): 1061-1064.
2.	Torre M, Reda M, Musso V, et al. Diagnostic accuracy of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging of lung cancer. Mediastinum, 2021, 5: 15.
3.	馮靖. 介入呼吸病學的快速現場評價. 現代實用醫學, 2016, 28(1): 5-7.
4.	國家衛計委海峽兩岸醫藥衛生交流協會呼吸病學專業委員會, 中華醫學會結核病學分會呼吸內鏡專業委員會, 中國醫師協會兒科學分會內鏡專業委員會, 等. 診斷性介入肺臟病學快速現場評價臨床實施指南. 天津醫藥, 2017, 45(4): 441-448.
5.	Gianella P, Soccal PM, Plojoux J, et al. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration in malignant and nonmalignant disease. Acta Cytol, 2018, 62(5-6): 380-385.
6.	Xu C, Liu W, Wang W, et al. Diagnostic value of endobronchial ultrasound combined with rapid on-site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions. Diagn Cytopathol, 2021, 49(6): 706-710.
7.	Yarmus L, Van der Kloot T, Lechtzin N, et al. A randomized prospective trial of the utility of rapid on-site evaluation of transbronchial needle aspirate specimens. J Bronchology Interv Pulmonol, 2011, 18(2): 121-127.
8.	鄔蘭, 張永, 曾憲濤. QUADAS-2在診斷準確性研究的質量評價工具中的應用. 湖北醫藥學院學報, 2013, 32(3): 201-208.
9.	Collins BT, Chen AC, Wang JF, et al. Improved laboratory resource utilization and patient care with the use of rapid on-site evaluation for endobronchial ultrasound fine-needle aspiration biopsy. Cancer Cytopathol, 2013, 121(10): 544-551.
10.	Oki M, Saka H, Kitagawa C, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: A randomized study. Respiration, 2013, 85(6): 486-492.
11.	Chen CH, Cheng WC, Wu BR, et al. Improved diagnostic yield of bronchoscopy in peripheral pulmonary lesions: Combination of radial probe endobronchial ultrasound and rapid on-site evaluation. J Thorac Dis, 2015, 7(Suppl 4): S418-S425.
12.	Guo H, Liu S, Guo J, et al. Rapid on-site evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of hilar and mediastinal lymphadenopathy in patients with lung cancer. Cancer Lett, 2016, 371(2): 182-186.
13.	Cardoso AV, Neves I, Magalh?es A, et al. The value of rapid on-site evaluation during EBUS-TBNA. Rev Port Pneumol (2006), 2015, 21(5): 253-258.
14.	Madan K, Dhungana A, Mohan A, et al. Conventional transbronchial needle aspiration versus endobronchial ultrasound-guided transbronchial needle aspiration, with or without rapid on-site evaluation, for the diagnosis of sarcoidosis: A randomized controlled trial. J Bronchology Interv Pulmonol, 2017, 24(1): 48-58.
15.	Xu CH, Wang JW, Wang W, et al. The diagnosis value of endobronchial ultrasound transbronchial lung biopsy combined with rapid on-site evaluation in peripheral lung cancer. Clin Respir J, 2020, 14(5): 447-452.
16.	Qi JC, Liao L, Zhao Z, et al. Impact of rapid on-site evaluation combined with endobronchial ultrasound and virtual bronchoscopic navigation in diagnosing peripheral lung lesions. BMC Pulm Med, 2022, 22(1): 117.
17.	張磊, 葉聯華, 陳穎, 等. 現場快速評估在經超聲支氣管鏡針吸活檢中的應用評價. 中國當代醫藥, 2017, 24(24): 7-10.
18.	向青, 萬濤, 胡前方, 等. 快速現場細胞學評價在EBUS-TBNA取樣診斷肺癌中的價值. 中國肺癌雜志, 2018, 21(11): 833-840.
19.	陳偉莊, 王輝, 李優, 等. 快速現場評價在經氣管鏡超聲引導針吸活檢診斷縱隔病灶中的應用. 中國內鏡雜志, 2021, 27(4): 44-51.
20.	張凱峰. EBUS-TBNA聯合ROSE診斷縱隔/肺門淋巴結腫大的應用價值研究. 吉林大學, 2020.
21.	張祿琴. 超聲引導下經支氣管針吸活檢結合快速現場評估對縱隔、肺門病變的臨床應用價值. 寧夏醫科大學, 2021.
22.	Miller KD, Goding Sauer A, Ortiz AP, et al. Cancer statistics for hispanics/latinos, 2018. CA Cancer J Clin, 2018, 68(6): 425-445.
23.	王哲, 吳齊飛, 張廣健, 等. 電視縱隔鏡手術應用于胸外科40例. 中國胸心血管外科臨床雜志, 2017, 24(12): 957-961.
24.	劉海燕, 劉杰, 宋健, 等. 超聲支氣管鏡引導下針吸活檢術對縱隔及肺部病變診斷價值. 現代儀器與醫療, 2018, 24(6): 40-41, 90.
25.	Mehta AC, Wang KP. Teaching conventional transbronchial needle aspiration. A continuum. Ann Am Thorac Soc, 2013, 10(6): 685-689.
26.	S?rhaug S, Hjelde H, Hatlen P, et al. Learning endobronchial ultrasound transbronchial needle aspiration—A 6-year experience at a single institution. Clin Respir J, 2018, 12(1): 40-47.
27.	Sehgal IS, Dhooria S, Aggarwal AN, et al. Impact of rapid on-site cytological evaluation (ROSE) on the diagnostic yield of transbronchial needle aspiration during mediastinal lymph node sampling: Systematic review and meta-analysis. Chest, 2018, 153(4): 929-938.
28.	金旭如, 陳成水. 淺談快速現場評價在呼吸系統疾病診斷中的應用. 中華結核和呼吸雜志, 2018, 41(6): 507-508.
29.	Chen X, Wan B, Xu Y, et al. Efficacy of rapid on-site evaluation for diagnosing pulmonary lesions and mediastinal lymph nodes: A systematic review and meta-analysis. Transl Lung Cancer Res, 2019, 8(6): 1029-1044.

1. 梁天齊, 張月強. 低劑量螺旋CT對篩查早期肺癌的臨床價值及準確性分析. 現代醫用影像學, 2022, 31(6): 1061-1064.
2. Torre M, Reda M, Musso V, et al. Diagnostic accuracy of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging of lung cancer. Mediastinum, 2021, 5: 15.
3. 馮靖. 介入呼吸病學的快速現場評價. 現代實用醫學, 2016, 28(1): 5-7.
4. 國家衛計委海峽兩岸醫藥衛生交流協會呼吸病學專業委員會, 中華醫學會結核病學分會呼吸內鏡專業委員會, 中國醫師協會兒科學分會內鏡專業委員會, 等. 診斷性介入肺臟病學快速現場評價臨床實施指南. 天津醫藥, 2017, 45(4): 441-448.
5. Gianella P, Soccal PM, Plojoux J, et al. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration in malignant and nonmalignant disease. Acta Cytol, 2018, 62(5-6): 380-385.
6. Xu C, Liu W, Wang W, et al. Diagnostic value of endobronchial ultrasound combined with rapid on-site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions. Diagn Cytopathol, 2021, 49(6): 706-710.
7. Yarmus L, Van der Kloot T, Lechtzin N, et al. A randomized prospective trial of the utility of rapid on-site evaluation of transbronchial needle aspirate specimens. J Bronchology Interv Pulmonol, 2011, 18(2): 121-127.
8. 鄔蘭, 張永, 曾憲濤. QUADAS-2在診斷準確性研究的質量評價工具中的應用. 湖北醫藥學院學報, 2013, 32(3): 201-208.
9. Collins BT, Chen AC, Wang JF, et al. Improved laboratory resource utilization and patient care with the use of rapid on-site evaluation for endobronchial ultrasound fine-needle aspiration biopsy. Cancer Cytopathol, 2013, 121(10): 544-551.
10. Oki M, Saka H, Kitagawa C, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: A randomized study. Respiration, 2013, 85(6): 486-492.
11. Chen CH, Cheng WC, Wu BR, et al. Improved diagnostic yield of bronchoscopy in peripheral pulmonary lesions: Combination of radial probe endobronchial ultrasound and rapid on-site evaluation. J Thorac Dis, 2015, 7(Suppl 4): S418-S425.
12. Guo H, Liu S, Guo J, et al. Rapid on-site evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of hilar and mediastinal lymphadenopathy in patients with lung cancer. Cancer Lett, 2016, 371(2): 182-186.
13. Cardoso AV, Neves I, Magalh?es A, et al. The value of rapid on-site evaluation during EBUS-TBNA. Rev Port Pneumol (2006), 2015, 21(5): 253-258.
14. Madan K, Dhungana A, Mohan A, et al. Conventional transbronchial needle aspiration versus endobronchial ultrasound-guided transbronchial needle aspiration, with or without rapid on-site evaluation, for the diagnosis of sarcoidosis: A randomized controlled trial. J Bronchology Interv Pulmonol, 2017, 24(1): 48-58.
15. Xu CH, Wang JW, Wang W, et al. The diagnosis value of endobronchial ultrasound transbronchial lung biopsy combined with rapid on-site evaluation in peripheral lung cancer. Clin Respir J, 2020, 14(5): 447-452.
16. Qi JC, Liao L, Zhao Z, et al. Impact of rapid on-site evaluation combined with endobronchial ultrasound and virtual bronchoscopic navigation in diagnosing peripheral lung lesions. BMC Pulm Med, 2022, 22(1): 117.
17. 張磊, 葉聯華, 陳穎, 等. 現場快速評估在經超聲支氣管鏡針吸活檢中的應用評價. 中國當代醫藥, 2017, 24(24): 7-10.
18. 向青, 萬濤, 胡前方, 等. 快速現場細胞學評價在EBUS-TBNA取樣診斷肺癌中的價值. 中國肺癌雜志, 2018, 21(11): 833-840.
19. 陳偉莊, 王輝, 李優, 等. 快速現場評價在經氣管鏡超聲引導針吸活檢診斷縱隔病灶中的應用. 中國內鏡雜志, 2021, 27(4): 44-51.
20. 張凱峰. EBUS-TBNA聯合ROSE診斷縱隔/肺門淋巴結腫大的應用價值研究. 吉林大學, 2020.
21. 張祿琴. 超聲引導下經支氣管針吸活檢結合快速現場評估對縱隔、肺門病變的臨床應用價值. 寧夏醫科大學, 2021.
22. Miller KD, Goding Sauer A, Ortiz AP, et al. Cancer statistics for hispanics/latinos, 2018. CA Cancer J Clin, 2018, 68(6): 425-445.
23. 王哲, 吳齊飛, 張廣健, 等. 電視縱隔鏡手術應用于胸外科40例. 中國胸心血管外科臨床雜志, 2017, 24(12): 957-961.
24. 劉海燕, 劉杰, 宋健, 等. 超聲支氣管鏡引導下針吸活檢術對縱隔及肺部病變診斷價值. 現代儀器與醫療, 2018, 24(6): 40-41, 90.
25. Mehta AC, Wang KP. Teaching conventional transbronchial needle aspiration. A continuum. Ann Am Thorac Soc, 2013, 10(6): 685-689.
26. S?rhaug S, Hjelde H, Hatlen P, et al. Learning endobronchial ultrasound transbronchial needle aspiration—A 6-year experience at a single institution. Clin Respir J, 2018, 12(1): 40-47.
27. Sehgal IS, Dhooria S, Aggarwal AN, et al. Impact of rapid on-site cytological evaluation (ROSE) on the diagnostic yield of transbronchial needle aspiration during mediastinal lymph node sampling: Systematic review and meta-analysis. Chest, 2018, 153(4): 929-938.
28. 金旭如, 陳成水. 淺談快速現場評價在呼吸系統疾病診斷中的應用. 中華結核和呼吸雜志, 2018, 41(6): 507-508.
29. Chen X, Wan B, Xu Y, et al. Efficacy of rapid on-site evaluation for diagnosing pulmonary lesions and mediastinal lymph nodes: A systematic review and meta-analysis. Transl Lung Cancer Res, 2019, 8(6): 1029-1044.

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Rapid on-site evaluation combined with endobronchial ultrasound for the diagnosis of pulmonary/mediastinal lesions: A systematic review and meta-analysis

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