Key Points
• In the current study, researchers assessed endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the analysis of epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and programmed death-ligand 1 (PD-L1) status.
• EBUS-TBNA is a minimally invasive method for diagnosing and staging lung cancer. Rapid on-site cytologic evaluation (ROSE) is a complementary test to gauge the adequacy of the collected samples. ROSE identifies malignant cells, as well as sometimes diagnosing during the procedure.
• “ROSE represents an important tool, since it can not only provide information about the quality of the tissue obtained, but also shorten the time of the EBUS-TBNA procedure, by reducing the number of punctures per lymph node. It also lowers the necessity for additional procedures in order to reach a diagnosis,” the authors wrote.
• According to the authors, ROSE can be used for screening because it exhibited a high sensitivity ( %) and positive predictive value (93.65%) for NSCLC diagnosis, as well as a moderate specificity (75%) and negative predictive value (70.58%).
• The authors concluded, “ROSE proved to have a moderate prediction of the final diagnosis in NSCLC. Molecular analysis of EGFR, ALK and PD-L1 can be successfully accomplished on EBUS-TBNA small tissue samples.”
• Limitations of the current study include the small sample size tested for molecular alterations. Furthermore, tumor heterogeneity could have resulted in non-representative samples of the lung tumor. Another limitation is that the study was performed in Romania where PET-CT is only performed in select patients.