The use of EBUS-TBNA and ROSE in the diagnosis of lung cancer

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive method for diagnosing and staging of lung cancer. EBUS-TBNA obtained small specimens. Rapid on-site examination (ROSE) is a rapid, real-time examination method. The aim of our study is to evaluate the impact of ROSE on adequate specimen sampling, rapid results and high diagnostic rate. We present the experience of the Department of Bronchology, "Leon Daniello" Clinic of Pulmonology, Cluj-Napoca, Romania, with EBUS-TBNA as a tool for diagnostic of adenopathies of unknown etiology. We evaluated the diagnostic capacity of ROSE for malignant tumors, by considering the histopathological examination as the diagnostic "gold standard". In our retrospective and descriptive study, we analyze the data of 147 EBUS-TBNA examinations with ROSE and histopathological exam, performed for diagnostic purposes for hilar and mediastinal adenopathies of unknown origin. The age of the patients varied from 21 to 80 years, with an average age of 54.36 years. There were 98 male patients, representing 66.66% of the group. From the total of 90 cases of malignancy, 72 (80%) cases were identified as a primary lung tumor, 13 (14.44%) cases were identified as lymphoma, and five cases as malignant tumor of extrapulmonary origin. The sensitivity of the ROSE is 85.71%. By the introduction of this method, EBUS-TBNA with ROSE, in our country, we can diagnose patients with lung and mediastinal tumors, which cannot be diagnosed by traditional bronchoscopy. This brings a valuable contribution to the improvement of lung cancer diagnostic.