Premium
Molecular testing on endobronchial ultrasound (EBUS) fine needle aspirates (FNA): Impact of triage
Author(s) -
Sung Simon,
Crapanzano John P.,
DiBardino David,
Swinarski David,
Bulman William A.,
Saqi Anjali
Publication year - 2018
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.23861
Subject(s) - medicine , triage , endobronchial ultrasound , radiology , cytology , cytopathology , technician , fine needle aspiration , lung cancer , biopsy , bronchoscopy , pathology , emergency medicine , electrical engineering , engineering
Background Endobronchial ultrasound (EBUS)‐guided fine needle aspiration (FNA) is performed to diagnose and stage lung cancer. Multiple studies have described the value of Rapid On‐Site Evaluation (ROSE), but often the emphasis is upon diagnosis than adequacy for molecular testing (MT). The aim was to identify variable(s), especially cytology‐related, that can improve MT. Methods A search for EBUS‐FNAs with ROSE was conducted for lung adenocarcinomas or when this diagnosis could not be excluded. All such cases underwent reflex MT on cell blocks. The impact of cytology‐related variables [i.e., number of pass(es), dedicated pass(es) directly into media, cytotechnologist (CT), laboratory technician (LT) and triage with 1 or >1 cytologist] was evaluated. The latter category was divided into Group A [ROSE, triage and slide preparation by cytopathologist (CP) and CT at start of the procedure] and Group B (ROSE only by CT or by CT/CP after start of procedure; triage and slide preparation by CT or clinical staff). The impact of all these variables on MT was assessed. Results A total of 100 cases were identified, and 79 had sufficient tissue for MT. Of all variables evaluated, MT was positively affected by performing a direct dedicated pass ( P = 0.013) and ROSE by Group A ( P = 0.033). Conclusions ROSE with appropriate triage, including performing a dedicated pass and proper slide preparation, improves MT, and this is enhanced by having >1 cytologist at the start of the procedure. In the era of personalized medicine, “adequate” should denote sufficient tissue for diagnosis and MT.