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KMID : 0359020080370050328
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Korean Journal of Gastrointestinal Endoscopy
2008 Volume.37 No. 5 p.328 ~ p.334
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Endoscopic Ultrasonography-guided Tru-Cut Biopsy for Differential Diagnosis in the Gastrointestinal Mesenchymal Neoplasm
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Kang Hyoun-Woo
Kim Joo-Sung
Kim Sang-Gyun
Kang Hae-Yeon
Jung Hyun-Chae
Song In-Sung
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Abstract
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Background/Aims: Risk assessment by mitotic count in the gastrointestinal stromal tumor (GIST), the most common mesenchymal neoplasm, is important. EUS-guided fine- needle aspiration cannot obtain sufficient tissue for determination of mitotic count, but An EUS-guided Tru-Cut biopsy (EUS-TCB) can. The aim of this study was to evaluate clinical role of EUS-TCB in differential diagnosis of mesenchymal neoplasm and risk assessment of GIST.
Methods: We prospectively enrolled 18 patients who were diagnosed with submucosal hypoechoic tumors, 2~5 cm, in the muscular layer by EUS in Seoul National University Hospital from November, 2005, to July, 2007. The rates of adequate biopsy and possibility of risk assessment were evaluated.
Results: EUS-TCB was performed in 16 patients. The median tumor size was 2.7 cm, and adequate diagnosis was possible in 8 patients. Tumor size in the adequate specimen group was larger than in the inadequate group (p=0.021). The number of needle passes was higher in the adequate specimen group (p=0.012). Risk assessment by mitotic count was possible in only one case.
Conclusions: EUS-TCB in the diagnosis and risk assessment of GIST was inadequate, in part because of insufficient operator experience and small tumors. Development of a new instrument is needed to obtain sufficient tissue.
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KEYWORD
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Mesenchymal neoplasm, Gastrointestinal stromal tumor, EUS-guided Tru-Cut biopsy
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