title: Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: a randomized study.
abstract: BACKGROUND
  Although rapid on-site cytologic evaluation (ROSE) is widely used during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), its role remains unclear.
  
  
  OBJECTIVE
  The purpose of the present study was to evaluate the efficacy of ROSE during EBUS-TBNA in the diagnosis of lung cancer.
  
  
  METHODS
  One hundred and twenty patients highly suspected of having lung cancer who had hilar/mediastinal lymphadenopathy or a tumor adjacent to the central airway were enrolled in this study and randomized to undergo EBUS-TBNA with or without ROSE.
  
  
  RESULTS
  Twelve patients with visible endobronchial lesions were excluded in the analysis. Thus, a total of 108 patients (55 in the ROSE group, 53 in the non-ROSE group) were analyzed. Additional procedures including EBUS-TBNA for lesions other than the main target lesion and/or transbronchial biopsy in the same setting were performed in 11% of patients in the ROSE group and 57% in the non-ROSE group (p < 0.001). Mean puncture number was significantly lower in the ROSE group (2.2 vs. 3.1 punctures, p < 0.001), and mean bronchoscopy time was similar between both groups (22.3 vs. 22.1 min, p = 0.95). The sensitivity and accuracy for diagnosing lung cancer were 88 and 89% in the ROSE group, and 86 and 89% in the non-ROSE group, respectively. No complications were associated with the procedures.
  
  
  CONCLUSIONS
  ROSE during EBUS-TBNA is associated with a significantly lower need for additional bronchoscopic procedures and puncture number.
authors.affiliation: Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan. masahideo@aol.com
authors.forename: Masahide
authors.initials: M
authors.lastname: Oki
authors.forename: Hideo
authors.initials: H
authors.lastname: Saka
authors.forename: Chiyoe
authors.initials: C
authors.lastname: Kitagawa
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Kogure
authors.forename: Naohiko
authors.initials: N
authors.lastname: Murata
authors.forename: Takashi
authors.initials: T
authors.lastname: Adachi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ando
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies