Rapid on-site evaluation (ROSE) of image-guided FNA specimens improves subsequent core biopsy adequacy in clinical trial patients: The impact of preanalytical factors and its correlation with survival.

Autor: Graham AJ; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Robinson MT; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Kahler J; Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA., Azadi JR; Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Maleki Z; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jazyk: angličtina
Zdroj: Cancer cytopathology [Cancer Cytopathol] 2024 Jan; Vol. 132 (1), pp. 30-40. Date of Electronic Publication: 2023 Sep 28.
DOI: 10.1002/cncy.22764
Abstrakt: Background: Sufficient tumor collection has become of utmost importance in therapeutic experimental protocols. Rapid on-site evaluation (ROSE) ensures adequate sampling for quantification of biomarkers, molecular analyses, and other ancillary studies. The objectives of this study were to evaluate the role of ROSE in trial-associated fine-needle aspiration (FNA) and to analyze predictors of adequacy and cumulative survival from in-house FNA cases used in clinical trials.
Methods: Clinical trial FNA biopsies performed at a large academic institution were analyzed over 10 months using a comprehensive chart review of the electronic medical records. SPSS version 28 was used for statistical analysis.
Results: Three hundred twenty-five FNAs were collected for 57 clinical trials. In total, 225 individual patients had an average of 1.4 FNA procedures each as a result of a multidepartmental collaborative effort. ROSE was performed for all patients, and adequacy was evaluated by cytotechnologists. Seventy-eight percent of samples were considered adequate, 14% were considered less than optimal, and 8% were considered inadequate, with the latter two categories designated together as less than adequate. The imaging modalities were mainly ultrasound-guided (n = 267; 82%) and computed tomography-guided (n = 58; 18%). There was a statistically significant association between adequate sampling and ultrasound-guided biopsies (83%) compared with computed tomography-guided biopsies (59%; p < .01). The effect of body mass index (BMI) on mortality was also a significant finding. The authors observed a survival benefit in patients who had elevated BMIs (range, 25.0-34.9 kg/m 2 ) compared with those who were underweight (BMI, <18.5 kg/m 2 ) or class III obese (BMI, >35.0 kg/m 2 ; p < .01). Therefore, the best predictors of adequacy and mortality were imaging modality and BMI, respectively.
Conclusions: Ultrasound-guided modalities are recommended for obtaining adequate FNA sampling for clinical trials. In addition, patients with cancer who had slightly elevated BMIs (25.0-34.0 kg/m 2 ) had increased overall survival in this cohort.
(© 2023 American Cancer Society.)
Databáze: MEDLINE
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