To analyze the application of bronchoscopy combined with rapid on-site cytologic evaluation(C-ROSE).

Retrospective study of 240 cases who were performed with bronchoscopy at the Second Affiliated Hospital of Nanjing Medical University in 2020. There were 79 cases in C-Rose group and 161 cases in non-C-Rose group. The diagnostic yield and the secondary examination rates between C-ROSE group and non C-ROSE group were also compared.

Compared with the gold standard, the pulmonologist′s interpretation of sample adequacy, identification of benign and malignant lesions, and diagnosis of lung cancer were all highly consistent, the Kappa value were 0.904, 0.970, 0.794 respectively. When C-ROSE was applied to bronchoscopy, the diagnostic efficacy was pretty good, the sensitivity was 100%, the specificity was 97.83%, the diagnostic accuracy was 98.61%, the positive predictive value was 96.30% and the negative predictive value was 100%. The diagnostic yield of malignant disease was statistically higher in C-ROSE group than that in non C-ROSE group(92.86% vs. 73.21%, P<0.05). There was no statistical difference between the two groups in the total diagnostic yield and the benign disease diagnostic yield. The secondary examination rate of malignant disease was statistically lower than that in non C-ROSE group(7.14% vs. 26.79%, P<0.05).

Pulmonologists can master C-ROSE technique after short time of systematic training. A trained pulmonologist can reliably carry out C-ROSE to interpret sample adequacy, distinguish between benign and malignant lesions, help improve the diagnostic yield and reduce the secondary examination rate. C-ROSE technique is effective-cost, it worthy of wide use in most hospitals.