PDF(Pubmed)
Abstract：
UNASSIGNED: For gastric subepithelial lesions (GSELs) showing a hypoechoic mass (HM) on endoscopic ultrasonography (EUS) imaging, the utility of EUS-guided tissue acquisition using conventional fine-needle aspiration needles (EUS-TA-CFNAN) and the frequency of histological types remain unclear. This study aimed to examine this issue.
UNASSIGNED: This prospective observational study enrolled 291 consecutive patients who underwent EUS-TA-CFNAN for GSELs showing an HM (GSELHM) on EUS imaging. Immunohistochemical analysis was performed for all EUS-TA-CFNAN and surgically resected specimens. The main outcome measures were the technical results of EUS-TA-CFNAN and the frequency of histological types in GSELHM.
UNASSIGNED: The endoscopic ultrasound-guided tissue acquisition using conventional fine-needle aspiration needle diagnosis rate for GSELHM was 80.1% (95% confidence interval [CI]: 75.0-84.5, 233/291). It was significantly lower for antrum (P = 0.004) and lesions smaller than 2 cm (P = 0.003). There were no adverse events. The immunohistochemical diagnoses of EUS-TA-CFNAN included 149 cases of gastrointestinal stromal tumour (GIST) (51.2%), 48 cases of leiomyoma (16.5%), 11 cases of schwannoma (3.8%), 8 cases of the ectopic pancreas (2.7%), 5 cases of subepithelial lesion like cancer (1.7%), 12 cases of other lesions (4.1%), and 58 cases of undiagnosable lesions (19.9%). The frequency of malignant or potentially malignant tumour in GSELHM was 55.0% (95% CI: 49.1-60.8, 160/291). Surgery was performed in 149 patients according to the conclusive EUS-TA-CFNAN results, in which the diagnostic accuracy of EUS-TA-CFNAN was 97.3% (95% CI: 94.7-99.9, 145/149).
UNASSIGNED: The use of EUS-TA-CFNAN for GSELHMs is safe and accurate. Gastric subepithelial lesions showing a hypoechoic mass have a reasonably high possibility of containing malignant or potentially malignant tumours, including GISTs.
UNASSIGNED: This prospective observational study enrolled 291 consecutive patients who underwent EUS-TA-CFNAN for GSELs showing an HM (GSELHM) on EUS imaging. Immunohistochemical analysis was performed for all EUS-TA-CFNAN and surgically resected specimens. The main outcome measures were the technical results of EUS-TA-CFNAN and the frequency of histological types in GSELHM.
UNASSIGNED: The endoscopic ultrasound-guided tissue acquisition using conventional fine-needle aspiration needle diagnosis rate for GSELHM was 80.1% (95% confidence interval [CI]: 75.0-84.5, 233/291). It was significantly lower for antrum (P = 0.004) and lesions smaller than 2 cm (P = 0.003). There were no adverse events. The immunohistochemical diagnoses of EUS-TA-CFNAN included 149 cases of gastrointestinal stromal tumour (GIST) (51.2%), 48 cases of leiomyoma (16.5%), 11 cases of schwannoma (3.8%), 8 cases of the ectopic pancreas (2.7%), 5 cases of subepithelial lesion like cancer (1.7%), 12 cases of other lesions (4.1%), and 58 cases of undiagnosable lesions (19.9%). The frequency of malignant or potentially malignant tumour in GSELHM was 55.0% (95% CI: 49.1-60.8, 160/291). Surgery was performed in 149 patients according to the conclusive EUS-TA-CFNAN results, in which the diagnostic accuracy of EUS-TA-CFNAN was 97.3% (95% CI: 94.7-99.9, 145/149).
UNASSIGNED: The use of EUS-TA-CFNAN for GSELHMs is safe and accurate. Gastric subepithelial lesions showing a hypoechoic mass have a reasonably high possibility of containing malignant or potentially malignant tumours, including GISTs.
摘要：
■对于在超声内镜（EUS）成像中显示低回声肿块（HM）的胃上皮下病变（GSEL），使用常规细针抽吸针(EUS-TA-CFNAN)进行EUS引导组织采集的实用性和组织学类型的频率尚不清楚.本研究旨在探讨这一问题。
■这项前瞻性观察性研究招募了291名连续接受EUS-TA-CFNAN治疗的GSEL患者，这些患者在EUS成像中显示HM（GSELHM）。对所有EUS-TA-CFNAN和手术切除的标本进行免疫组织化学分析。主要结局指标是EUS-TA-CFNAN的技术结果和GSELHM中组织学类型的频率。
■使用常规细针抽吸针的内窥镜超声引导组织采集对GSELHM的诊断率为80.1%（95%置信区间[CI]：75.0-84.5，233/291）。胃窦（P=0.004）和小于2cm的病变（P=0.003）显着降低。无不良事件发生。EUS-TA-CFNAN的免疫组化诊断包括149例胃肠道间质瘤(GIST)(51.2%),平滑肌瘤48例（16.5%），神经鞘瘤11例(3.8%),异位胰腺8例（2.7%），上皮下病变样癌5例（1.7%），其他病变12例(4.1%),58例不可诊断的病变（19.9％）。GSELHM中恶性或潜在恶性肿瘤的发生率为55.0％（95％CI：49.1-60.8，160/291）。根据最终的EUS-TA-CFNAN结果，对149例患者进行了手术，其中EUS-TA-CFNAN的诊断准确率为97.3%(95%CI:94.7-99.9,145/149).
■将EUS-TA-CFNAN用于GSELHM是安全且准确的。表现出低回声肿块的胃上皮下病变具有相当高的恶性或潜在恶性肿瘤的可能性。包括GISTS。
■这项前瞻性观察性研究招募了291名连续接受EUS-TA-CFNAN治疗的GSEL患者，这些患者在EUS成像中显示HM（GSELHM）。对所有EUS-TA-CFNAN和手术切除的标本进行免疫组织化学分析。主要结局指标是EUS-TA-CFNAN的技术结果和GSELHM中组织学类型的频率。
■使用常规细针抽吸针的内窥镜超声引导组织采集对GSELHM的诊断率为80.1%（95%置信区间[CI]：75.0-84.5，233/291）。胃窦（P=0.004）和小于2cm的病变（P=0.003）显着降低。无不良事件发生。EUS-TA-CFNAN的免疫组化诊断包括149例胃肠道间质瘤(GIST)(51.2%),平滑肌瘤48例（16.5%），神经鞘瘤11例(3.8%),异位胰腺8例（2.7%），上皮下病变样癌5例（1.7%），其他病变12例(4.1%),58例不可诊断的病变（19.9％）。GSELHM中恶性或潜在恶性肿瘤的发生率为55.0％（95％CI：49.1-60.8，160/291）。根据最终的EUS-TA-CFNAN结果，对149例患者进行了手术，其中EUS-TA-CFNAN的诊断准确率为97.3%(95%CI:94.7-99.9,145/149).
■将EUS-TA-CFNAN用于GSELHM是安全且准确的。表现出低回声肿块的胃上皮下病变具有相当高的恶性或潜在恶性肿瘤的可能性。包括GISTS。
