{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T13:22:06Z","timestamp":1788009726907,"version":"build-2784847793"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Medical thoracoscopy (MT) plays an important role in the diagnosis and treatment of pleural diseases, and rapid on-site evaluation (ROSE) has long been used for transbronchial needle aspiration or fine-needle aspiration to evaluate the adequacy of biopsy materials for the diagnosis of peripheral lung lesions. However, research on ROSE combined with MT for the management of pleural disease has been rarely reported. We aimed to evaluate the diagnostic performance of ROSE for pleura biopsies and visual diagnosis by thoracoscopists for gross thoracoscopic appearance. The secondary objective was to assess the intermodality agreement between ROSE and the final histopathologic diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 579 patients with exudative pleural effusion (EPE) who underwent MT combined with ROSE from February 2017 to December 2020 at Taihe Hospital were included in the study. Thoracoscopists' visual diagnosis of gross thoracoscopic appearance, ROSE results, histopathologic findings, and the final diagnosis was recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thoracoscopic pleural biopsies were performed in 565 patients (97.6%); 183 patients were confirmed to have malignant pleural effusion (MPE), and 382 patients were confirmed to have benign pleural effusion (BPE). The area under the curve of ROSE for the diagnosis of MPE was 0.96 (95% CI: 0.94\u20130.98, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), with a sensitivity of 98.7%, a specificity of 97.2%, a diagnostic accuracy of 97.1%, a positive predictive value of 97.2%, and a negative predictive value of 97.2%. Diagnostic consistency between ROSE and histopathology was good (\u03ba \u00b1 SE = 0.93 \u00b1 0.02, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). The area under the curve of the thoracoscopists' visual diagnosis of gross thoracoscopic appearance was 0.79 (95% CI: 0.75\u20130.83, <jats:italic>p<\/jats:italic> &amp;lt; 0.01), with a sensitivity of 76.7%, a specificity of 80.9%, a positive predictive value of 62.4%, and a negative predictive value of 89.3%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ROSE of touch imprints of MT biopsy tissue during MT showed high accuracy for distinguishing between benign and malignant lesions. In addition, ROSE was in good agreement with the histopathological diagnosis, which may help thoracoscopists perform pleurodesis (talc poudrage) directly during the procedure, especially in patients with malignant results.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1196000","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T05:08:30Z","timestamp":1686287310000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Rapid on-site evaluation of touch imprints of medical thoracoscopy biopsy tissue for the management of pleural disease"],"prefix":"10.3389","volume":"10","author":[{"given":"Hansheng","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiankun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoshi","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meifang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"P11","DOI":"10.1164\/rccm.1946P11","article-title":"Malignant pleural effusions","volume":"194","author":"Semaan","year":"2016","journal-title":"Am J Respir Crit Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"377","DOI":"10.3238\/arztebl.2019.0377","article-title":"Pleural effusion in adults-etiology, diagnosis, and treatment","volume":"116","author":"Jany","year":"2019","journal-title":"Dtsch Arztebl Int."},{"key":"B3","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1055\/s-0038-1676978","article-title":"Thoracoscopy: advances and increasing role for interventional pulmonologists","volume":"39","author":"Lee","year":"2018","journal-title":"Semin Respir Crit Care Med."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.136978","article-title":"Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010","author":"Hooper","year":"2010","journal-title":"Thorax."},{"key":"B5","doi-asserted-by":"publisher","first-page":"5049248","DOI":"10.1155\/2019\/5049248","article-title":"The utility of rapid on-site evaluation during bronchoscopic biopsy: a 2-year respiratory endoscopy central experience","volume":"2019","author":"Wang","year":"2019","journal-title":"Biomed Res Int."},{"key":"B6","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1093\/jjco\/hyaa245","article-title":"Rapid on-site evaluation of touch imprints of biopsies improves the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy: a retrospective study","volume":"51","author":"Wang","year":"2021","journal-title":"Jpn J Clin Oncol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"9842768","DOI":"10.1155\/2020\/9842768","article-title":"Diagnostic value of rapid on-site evaluation for CT-guided percutaneous fine needle aspiration in the diagnosis of pulmonary occupying lesions","volume":"2020","author":"Peng","year":"2020","journal-title":"Biomed Res Int."},{"key":"B8","doi-asserted-by":"publisher","first-page":"229","DOI":"10.4103\/JOC.JOC_134_17","article-title":"Role of rapid on-site evaluation in CT-guided fine needle aspiration cytology of lung nodules","volume":"35","author":"Anila","year":"2018","journal-title":"J Cytol."},{"key":"B9","unstructured":"Rapid on-site evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of hilar and mediastinal lymphadenopathy in patients with lung cancer1826\n            GuoH\n            LiuS\n            GuoJ\n            LiB\n            LiW\n            LuZ\n          10.1016\/j.canlet.2015.11.03826656954Cancer Lett.3712016"},{"key":"B10","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1159\/000346987","article-title":"Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: a randomized study","volume":"85","author":"Oki","year":"2013","journal-title":"Respiration."},{"key":"B11","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1378\/chest.10-1521","article-title":"Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy: a randomized trial","volume":"139","author":"Trisolini","year":"2011","journal-title":"Chest."},{"key":"B12","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1378\/chest.128.2.869","article-title":"Impact of rapid on-site cytologic evaluation during transbronchial needle aspiration","volume":"128","author":"Baram","year":"2005","journal-title":"Chest."},{"key":"B13","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1183\/09031936.06.00013706","article-title":"Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion","volume":"28","author":"Rodriguez-Panadero","year":"2006","journal-title":"Eur Respir J."},{"key":"B14","doi-asserted-by":"publisher","first-page":"S339","DOI":"10.3978\/j.issn.2072-1439.2015.11.66","article-title":"Thoracoscopy: medical versus surgical-in the management of pleural diseases","volume":"7","author":"Shojaee","year":"2015","journal-title":"J Thorac Dis."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.137000","article-title":"Management of pleural infection in adults: British Thoracic Society Pleural Disease Guideline 2010","author":"Davies","year":"2010","journal-title":"Thorax."},{"key":"B16","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1097\/JTO.0b013e318206a221","article-title":"International association for the study of lung cancer\/american thoracic society\/european respiratory society international multidisciplinary classification of lung adenocarcinoma","volume":"6","author":"Travis","year":"2011","journal-title":"J Thorac Oncol."},{"key":"B17","author":"Suvarna","year":"2018","journal-title":"Bancroft's Theory and Practice of Histological Techniques."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1378\/chest.06-2352","article-title":"Pleural tuberculosis in the United States: incidence and drug resistance","volume":"131","author":"Baumann","year":"2007","journal-title":"Chest."},{"key":"B19","doi-asserted-by":"publisher","first-page":"235","DOI":"10.5588\/ijtld.11.0212","article-title":"Real-time PCR and Amplified MTD(R) for rapid detection of Mycobacterium tuberculosis in pulmonary specimens","volume":"16","author":"Chen","year":"2012","journal-title":"Int J Tuberc Lung Dis."},{"key":"B20","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.clinbiochem.2014.10.003","article-title":"Evaluation of three rapid assays for Mycobacterium tuberculosis complex detection in a comprehensive hospital from West China","volume":"48","author":"Hu","year":"2015","journal-title":"Clin Biochem."},{"key":"B21","doi-asserted-by":"publisher","first-page":"507","DOI":"10.7326\/0003-4819-77-4-507","article-title":"Pleural effusions: the diagnostic separation of transudates and exudates","volume":"77","author":"Light","year":"1972","journal-title":"Ann Intern Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1016\/j.rmed.2015.05.014","article-title":"Pleural neoplastic pathology","volume":"109","author":"Karpathiou","year":"2015","journal-title":"Respir Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1111\/crj.12597","article-title":"Advances in pleuroscopy","volume":"12","author":"Anevlavis","year":"2018","journal-title":"Clin Respir J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"106802","DOI":"10.1016\/j.rmed.2022.106802","article-title":"Update on the diagnosis and management of malignant pleural effusions","volume":"196","author":"Bashour","year":"2022","journal-title":"Respir Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.ccm.2013.04.001","article-title":"Medical pleuroscopy","volume":"34","author":"Bhatnagar","year":"2013","journal-title":"Clin Chest Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/j.ejcts.2010.01.057","article-title":"Outcome of patients with nonspecific pleuritis\/fibrosis on thoracoscopic pleural biopsies","volume":"38","author":"Davies","year":"2010","journal-title":"Eur J Cardiothorac Surg."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1002\/ccr3.2949","article-title":"Sago-like appearance of pleura in tuberculosis","volume":"8","author":"Dhungana","year":"2020","journal-title":"Clin Case Rep."},{"key":"B28","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1055\/a-1666-5851","article-title":"Visual diagnosis of pleural tuberculosis and its association with tissue biopsy, culture and Xpert assay","volume":"76","author":"Sumalani","year":"2022","journal-title":"Pneumologie."},{"key":"B29","doi-asserted-by":"publisher","first-page":"270","DOI":"10.4236\/jtr.2018.64024","article-title":"Diagnostic utility of sago-like nodules on gross thoracoscopic appearance in tuberculous pleural effusion and their correlation with final histo-microbiologic findings","volume":"6","author":"Thomas","year":"2018","journal-title":"J Tuberc Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1111\/resp.12799","article-title":"Rapid on-site evaluation with the Hemacolor rapid staining method of medical thoracoscopy biopsy specimens for the management of pleural disease","volume":"21","author":"Porfyridis","year":"2016","journal-title":"Respirology."},{"key":"B31","doi-asserted-by":"publisher","first-page":"189","DOI":"10.4103\/0970-9371.151128","article-title":"Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion","volume":"31","author":"Chandra","year":"2014","journal-title":"J Cytol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1016\/j.ejcts.2005.12.025","article-title":"The evidence on the effectiveness of management for malignant pleural effusion: a systematic review","volume":"29","author":"Tan","year":"2006","journal-title":"Eur J Cardiothorac Surg."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1245\/s10434-010-1447-8","article-title":"Is silver nitrate pleurodesis for patients with malignant pleural effusion feasible and safe when performed in an outpatient setting?","volume":"18","author":"Terra","year":"2011","journal-title":"Ann Surg Oncol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1159\/000371470","article-title":"Safety and systemic consequences of pleurodesis with three different doses of silver nitrate in patients with malignant pleural effusion","volume":"89","author":"Terra","year":"2015","journal-title":"Respiration."},{"key":"B35","doi-asserted-by":"publisher","first-page":"Cd002916","DOI":"10.1002\/14651858.CD002916.pub2","article-title":"Pleurodesis for malignant pleural effusions","volume":"2004","author":"Shaw","year":"2004","journal-title":"Cochr Database Syst Rev"},{"key":"B36","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1159\/000440727","article-title":"Safety profile of the use of iodopovidone for pleurodesis in patients with malignant pleural effusion","volume":"90","author":"Andrade Neto","year":"2015","journal-title":"Respiration."},{"key":"B37","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s11684-017-0609-5","article-title":"Recent transmission of Mycobacterium tuberculosis in China: the implication of molecular epidemiology for tuberculosis control","volume":"12","author":"Yang","year":"2018","journal-title":"Front Med."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.3760\/cma.j.cn112147-20220511-00403","article-title":"Chinese expert consensus on diagnosis of pleural effusion","volume":"45","year":"2022","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"key":"B39","first-page":"82","article-title":"Pulmonary paragonimiasis mimicking tuberculosis","volume":"63","author":"Prasad","year":"2015","journal-title":"J Assoc Phys India."},{"key":"B40","doi-asserted-by":"publisher","first-page":"8","DOI":"10.4103\/cytojournal.cytojournal_19_18","article-title":"Subtyping of non-small cell lung cancer by cytology specimens: a proposal for resource-poor hospitals","volume":"16","author":"Celik","year":"2019","journal-title":"Cytojournal."},{"key":"B41","doi-asserted-by":"publisher","first-page":"2095","DOI":"10.3390\/cells11132095","article-title":"Regeneration or repair? The role of alveolar epithelial cells in the pathogenesis of idiopathic pulmonary fibrosis (IPF)","volume":"11","author":"Confalonieri","year":"2022","journal-title":"Cells"},{"key":"B42","doi-asserted-by":"publisher","first-page":"00346","DOI":"10.1183\/23120541.00346-2021","article-title":"Radiological-pathological signatures of patients with COVID-19-related pneumomediastinum: is there a role for the Sonic hedgehog and Wnt5a pathways?","volume":"7","author":"Baratella","year":"2021","journal-title":"ERJ Open Res"},{"key":"B43","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.jasc.2015.06.005","article-title":"Rapid on-site evaluation improves fine-needle aspiration biopsy cell block quality","volume":"5","author":"Collins","year":"2016","journal-title":"J Am Soc Cytopathol."},{"key":"B44","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.jasc.2019.08.005","article-title":"Role of cytotechnologists in rapid onsite adequacy assessment of cytology materials for diagnostic workup and specimen allocation for ancillary testing using a standardized protocol","volume":"9","author":"Fetzer","year":"2020","journal-title":"J Am Soc Cytopathol."},{"key":"B45","first-page":"24","article-title":"Cytodiagnostics in pneumology - state of the art 2019","volume":"55","author":"Capkov\u00e1","year":"2019","journal-title":"Cesk Patol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1196000\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T05:08:37Z","timestamp":1686287317000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1196000\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,9]]},"references-count":45,"alternative-id":["10.3389\/fmed.2023.1196000"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1196000","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,9]]},"article-number":"1196000"}}