Clinical usefulness of endoscopic ultrasound-guided fine needle aspiration for gastric subepithelial lesions smaller than 2 cm

Kazuya Akahoshi, Masafumi Oya, Tadashi Koga, Hidenobu Koga, Yasuaki Motomura, Masaru Kubokawa, Jyuya Gibo, Kazuhiko Nakamura

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Abstract

Background & Aims: There is no evidence of postoperative metastasis of gastric gastrointestinal stromal tumors (GISTs) smaller than 2 cm. Te aim of this study was to evaluate the clinical usefulness of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) for gastric subepithelial lesions (SELs) smaller than 2 cm.

Patients and methods: Using a prospectively maintained EUS-FNA database, 90 consecutive EUS-FNAs of gastric hypoechoic solid SELs smaller than 2 cm diagnosed by EUS were evaluated retrospectively. Te reference standards for the final diagnosis were surgery (n=44) and/or clinical follow-up (n=46) using esophagogastroduodenoscopy (EGD), CT, and/or ultrasonography (US). Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens were compared.

Results: Te diagnostic rate of EUS-FNA for gastric hypoechoic solid SELs smaller than 2 cm was 73% (66/90). Histological diagnosis of EUS-FNA showed 47 (52%) malignant SELs (44 GISTs, 1 glomus tumor, 1 SEL like cancer, and 1 malignant lymphoma), 19 (21%) benign SELs (14 leiomyomas, 4 ectopic pancreas, and 1 neurinoma), and 24 (27%) indeterminate SELs. In 44 surgically respected cases, the diagnostic accuracy of EUS-FNA using immunohistochemical analysis was 98% (43/44). There were no complications. Appropriate management was performed in 65 out of 66 SELs (98%) diagnosed by definitive EUS-FNA. After surgery, there was no recurrence of malignant SELs.

Conclusions: EUS-FNA is an accurate and safe method in the pre-therapeutic diagnosis of gastric SELs smaller than 2 cm. EUS-FNA for gastric SELs smaller than 2 cm is a promising way to permit early management of patients with gastric SELs including GIST.

Original languageEnglish
Pages (from-to)405-412
Number of pages8
JournalJournal of Gastrointestinal and Liver Diseases
Volume23
Issue number4
Publication statusPublished - Dec 1 2014

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Stomach
Gastrointestinal Stromal Tumors
Digestive System Endoscopy
Glomus Tumor
Immunophenotyping
Neurilemmoma
Leiomyoma
Pancreas
Ultrasonography
Lymphoma
Databases

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Akahoshi, K., Oya, M., Koga, T., Koga, H., Motomura, Y., Kubokawa, M., ... Nakamura, K. (2014). Clinical usefulness of endoscopic ultrasound-guided fine needle aspiration for gastric subepithelial lesions smaller than 2 cm. Journal of Gastrointestinal and Liver Diseases, 23(4), 405-412.

Clinical usefulness of endoscopic ultrasound-guided fine needle aspiration for gastric subepithelial lesions smaller than 2 cm. / Akahoshi, Kazuya; Oya, Masafumi; Koga, Tadashi; Koga, Hidenobu; Motomura, Yasuaki; Kubokawa, Masaru; Gibo, Jyuya; Nakamura, Kazuhiko.

In: Journal of Gastrointestinal and Liver Diseases, Vol. 23, No. 4, 01.12.2014, p. 405-412.

Research output: Contribution to journalArticle

Akahoshi, K, Oya, M, Koga, T, Koga, H, Motomura, Y, Kubokawa, M, Gibo, J & Nakamura, K 2014, 'Clinical usefulness of endoscopic ultrasound-guided fine needle aspiration for gastric subepithelial lesions smaller than 2 cm', Journal of Gastrointestinal and Liver Diseases, vol. 23, no. 4, pp. 405-412.
Akahoshi, Kazuya ; Oya, Masafumi ; Koga, Tadashi ; Koga, Hidenobu ; Motomura, Yasuaki ; Kubokawa, Masaru ; Gibo, Jyuya ; Nakamura, Kazuhiko. / Clinical usefulness of endoscopic ultrasound-guided fine needle aspiration for gastric subepithelial lesions smaller than 2 cm. In: Journal of Gastrointestinal and Liver Diseases. 2014 ; Vol. 23, No. 4. pp. 405-412.
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abstract = "Background & Aims: There is no evidence of postoperative metastasis of gastric gastrointestinal stromal tumors (GISTs) smaller than 2 cm. Te aim of this study was to evaluate the clinical usefulness of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) for gastric subepithelial lesions (SELs) smaller than 2 cm.Patients and methods: Using a prospectively maintained EUS-FNA database, 90 consecutive EUS-FNAs of gastric hypoechoic solid SELs smaller than 2 cm diagnosed by EUS were evaluated retrospectively. Te reference standards for the final diagnosis were surgery (n=44) and/or clinical follow-up (n=46) using esophagogastroduodenoscopy (EGD), CT, and/or ultrasonography (US). Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens were compared.Results: Te diagnostic rate of EUS-FNA for gastric hypoechoic solid SELs smaller than 2 cm was 73{\%} (66/90). Histological diagnosis of EUS-FNA showed 47 (52{\%}) malignant SELs (44 GISTs, 1 glomus tumor, 1 SEL like cancer, and 1 malignant lymphoma), 19 (21{\%}) benign SELs (14 leiomyomas, 4 ectopic pancreas, and 1 neurinoma), and 24 (27{\%}) indeterminate SELs. In 44 surgically respected cases, the diagnostic accuracy of EUS-FNA using immunohistochemical analysis was 98{\%} (43/44). There were no complications. Appropriate management was performed in 65 out of 66 SELs (98{\%}) diagnosed by definitive EUS-FNA. After surgery, there was no recurrence of malignant SELs.Conclusions: EUS-FNA is an accurate and safe method in the pre-therapeutic diagnosis of gastric SELs smaller than 2 cm. EUS-FNA for gastric SELs smaller than 2 cm is a promising way to permit early management of patients with gastric SELs including GIST.",
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T1 - Clinical usefulness of endoscopic ultrasound-guided fine needle aspiration for gastric subepithelial lesions smaller than 2 cm

AU - Akahoshi, Kazuya

AU - Oya, Masafumi

AU - Koga, Tadashi

AU - Koga, Hidenobu

AU - Motomura, Yasuaki

AU - Kubokawa, Masaru

AU - Gibo, Jyuya

AU - Nakamura, Kazuhiko

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N2 - Background & Aims: There is no evidence of postoperative metastasis of gastric gastrointestinal stromal tumors (GISTs) smaller than 2 cm. Te aim of this study was to evaluate the clinical usefulness of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) for gastric subepithelial lesions (SELs) smaller than 2 cm.Patients and methods: Using a prospectively maintained EUS-FNA database, 90 consecutive EUS-FNAs of gastric hypoechoic solid SELs smaller than 2 cm diagnosed by EUS were evaluated retrospectively. Te reference standards for the final diagnosis were surgery (n=44) and/or clinical follow-up (n=46) using esophagogastroduodenoscopy (EGD), CT, and/or ultrasonography (US). Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens were compared.Results: Te diagnostic rate of EUS-FNA for gastric hypoechoic solid SELs smaller than 2 cm was 73% (66/90). Histological diagnosis of EUS-FNA showed 47 (52%) malignant SELs (44 GISTs, 1 glomus tumor, 1 SEL like cancer, and 1 malignant lymphoma), 19 (21%) benign SELs (14 leiomyomas, 4 ectopic pancreas, and 1 neurinoma), and 24 (27%) indeterminate SELs. In 44 surgically respected cases, the diagnostic accuracy of EUS-FNA using immunohistochemical analysis was 98% (43/44). There were no complications. Appropriate management was performed in 65 out of 66 SELs (98%) diagnosed by definitive EUS-FNA. After surgery, there was no recurrence of malignant SELs.Conclusions: EUS-FNA is an accurate and safe method in the pre-therapeutic diagnosis of gastric SELs smaller than 2 cm. EUS-FNA for gastric SELs smaller than 2 cm is a promising way to permit early management of patients with gastric SELs including GIST.

AB - Background & Aims: There is no evidence of postoperative metastasis of gastric gastrointestinal stromal tumors (GISTs) smaller than 2 cm. Te aim of this study was to evaluate the clinical usefulness of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) for gastric subepithelial lesions (SELs) smaller than 2 cm.Patients and methods: Using a prospectively maintained EUS-FNA database, 90 consecutive EUS-FNAs of gastric hypoechoic solid SELs smaller than 2 cm diagnosed by EUS were evaluated retrospectively. Te reference standards for the final diagnosis were surgery (n=44) and/or clinical follow-up (n=46) using esophagogastroduodenoscopy (EGD), CT, and/or ultrasonography (US). Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens were compared.Results: Te diagnostic rate of EUS-FNA for gastric hypoechoic solid SELs smaller than 2 cm was 73% (66/90). Histological diagnosis of EUS-FNA showed 47 (52%) malignant SELs (44 GISTs, 1 glomus tumor, 1 SEL like cancer, and 1 malignant lymphoma), 19 (21%) benign SELs (14 leiomyomas, 4 ectopic pancreas, and 1 neurinoma), and 24 (27%) indeterminate SELs. In 44 surgically respected cases, the diagnostic accuracy of EUS-FNA using immunohistochemical analysis was 98% (43/44). There were no complications. Appropriate management was performed in 65 out of 66 SELs (98%) diagnosed by definitive EUS-FNA. After surgery, there was no recurrence of malignant SELs.Conclusions: EUS-FNA is an accurate and safe method in the pre-therapeutic diagnosis of gastric SELs smaller than 2 cm. EUS-FNA for gastric SELs smaller than 2 cm is a promising way to permit early management of patients with gastric SELs including GIST.

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