The Technique of Rapid on-Site Evaluation on Lung Cancer

Abstract

Lung cancer is the first leading cause of death and the second most common malignancy in the world. Most of the lung carcinoma diagnostic specimens were obtained by cytologic modalities, such as transbronchial needle aspiration (TBNA), transthoracic needle aspiration (TTNA), and bronchial brushing. These small specimens are also used for immunocytochemistry/immunohistochemistry and molecular analysis. It is therefore very important to ensure that adequate specimens are obtained to prevent repeated interventions or unnecessary invasive procedures. The technique for determining the diagnosis and treatment options specified in one procedure is rapid on site evaluation (ROSE). ROSE procedure was initiated by making a smear from the specimen obtained through TBNA, bronchial brushing, TTNA, and imprinting the core needle biopsy. The smear slides were fixed immediately with a rapid stain and assessed for adequacy of the sample. The rapid stains used were Diff-Quik, rapid Papanicolau, rapid Hematoxylin Eosin, and toluidine blue (TB). The choice of stain is determined by the hospital's infrastructure in service, budget allocation, and the availability of trained cytology staff. The use of ROSE in cytology specimens can improve sample adequacy, diagnostic accuracy and has higher sensitivity.