To observe the diagnostic potential of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) combined with cytological rapid on-site evaluation (C-ROSE) in the space-occupying lesions of the lung and mediastinum.

It was an observational study.One hundred patients with space-occupying lesions of the lung and mediastinum admitted to Xinjiang Uiger Municipal People′s Hospital from June 2021 to December 2022 were enrolled.They were divided into the observation group (EBUS-TBNA combined with C-ROSE) and control group (EBUS-TBNA) by a random number table method, with 50 patients in each group.The general condition and puncture conditions (number of punctures, number of puncture sites, puncture depth and success rate of puncture) were compared between groups.The consistency of EBUS-TBNA and EBUS-TBNA combined with C-ROSE in diagnosing space-occupying lesions of the lung and mediastinum with the gold standard of postoperative pathology, and the diagnostic potential were assessed by the Kappa test and receiver operator characteristic (ROC) curves, respectively.The diameter of space-occupying lesions with different natures was compared.The complications after EBUS-TBNA were recorded.

There were no significant differences in gender, age, body mass index (BMI), ethnicity, smoking history and the maximum diameter of the space-occupying lesions between groups (all P>0.05).There were no significant differences in the number of punctures, number of puncture sites, puncture depth between groups (all P>0.05).Compared with that of the control group, the success rate of puncture was significantly higher in the observation group (100.00% [50/50] vs 88.00% [44/50]; χ²=4.43, P=0.035).The diagnostic results of EBUS-TBNA showed that there were 30 cases of malignant tumors and 20 cases of benign lesions in the control group, and the postoperative pathology showed 32 cases of malignant tumors and 18 cases of benign lesions in the control group.The diagnostic results of EBUS-TBNA combined with C-ROSE showed that there were 36 cases of malignant tumors and 14 cases of benign lesions in the observation group, and the postoperative pathology showed 37 cases of malignant tumors and 13 cases of benign lesions in the observation group.The diagnostic consistency of the observation group was significantly better than that of the control group (Kappa=0.746 vs 0.661).ROC curves revealed that the diagnostic performance of the observation group was significantly better than that of the control group, with the area under the curve (AUC) of 0.919 (95% CI: 0.874-0.964) and 0.826 (95% CI: 0.759-0.892), respectively.There were no significant differences in the diameter of malignant tumors ([1.72±0.56] cm vs [1.76±0.51] cm, t=0.37) and benign lesions ([1.48±0.45] cm vs [1.52±0.43] cm, t=0.45) between the control group and the observation group (P>0.05).Compared with that of the control group, the total incidence of complications in the observation group was significantly lower (4.00% [2/50] vs 16.00% [8/50]; χ²=4.00, P=0.046).

EBUS-TBNA combined with C-ROSE for the diagnosis of space-occupying lesions in the lung and mediastinum is helpful to improve the success rate of puncture and diagnostic efficiency and reduce the incidence of complications.

Lung diseases; Mediastinal diseases; Diagnosis; Endobronchial ultrasound-guided transbronchial needle aspiration; Cytological rapid on-site evaluation