Abstract

Background: Biopsy by Fine-Needle Aspiration guided by ultrasonography (EUS-FNA) with rapid on-site evaluation (ROSE) by cytopathologists improves diagnostic capacity of the EUS. 

Objectives: To assess whether the usefulness of ROSE performed by endoscopists with cytopathology training improves the adequacy of tissue sampling obtained by EUS-FNA. 

Methodology: Between March and October 2015, 49 patients with solid or cystic lesions of the gastrointestinal tract were taken to EUS-FNA. Two endoscopists with short training in cytopathology performed the ROSE and they categorized samples obtained as adequate or not adequate; the results were compared with the evaluation of a pathologist, using the same criteria to assess concordance.

Results: A high concordance of a proper reading between the endoscopist and pathologist in first EUS-FNA (EUS-FNA 1) (Kappa agreement measure 81%, sig = 0.000) and second EUS-FNA (EUS-FNA 2) (Kappa agreement measure 78%, sig = 0.001) was found.

Conclusion: Endoscopists can acquire basic skills in cytopathology to perform the ROSE and the findings are consistent with those made by a pathologist. This strategy can contribute to obtaining adequate samples for cytopathology diagnosis and improve EUS-FNA diagnostic capacity. Basic cytopathology should be included as a subject in endosonography and endoscopy programs.

Keywords: EUS-FNA; ROSE; On-site Cytology; Endosonography

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