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KMID : 1038120170500040372
Clinical Endoscopy
2017 Volume.50 No. 4 p.372 ~ p.378
Rapid On-Site Evaluation by Endosonographers during Endoscopic Ultrasonography-Guided Fine-Needle Aspiration for Diagnosis of Gastrointestinal Stromal Tumors
Mitamura Takashi

Yamashita Yasunobu
Ueda Kazuki
Kawaji Yuki
Itonaga Masahiro
Murata Shinichi
Yamamoto Kaori
Yoshida Takeichi
Maeda Hiroki
Maekita Takao
Iguchi Mikitaka
Tamai Hideyuki
Ichinose Masao
Kato Jun
Abstract
Background/Aims: Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has been used to diagnose gastrointestinal submucosal tumors (SMTs). Although rapid on-site evaluation (ROSE) has been reported to improve the diagnostic accuracy of EUS-FNA for pancreatic lesions, on-site cytopathologists are not routinely available. Given this background, the usefulness of ROSE by endosonographers themselves for pancreatic tumors has also been reported. However, ROSE by endosonographers for diagnosis of SMT has not been reported. The aim of this study was to evaluate the diagnostic accuracy of EUS-FNA with ROSE by endosonographers for SMT, focusing on diagnosis of gastrointestinal stromal tumor (GIST), compared with that of EUS-FNA alone.

Methods: Twenty-two consecutive patients who underwent EUS-FNA with ROSE by endosonographers for SMT followed by surgical resection were identified. Ten historical control subjects who underwent EUS-FNA without ROSE were used for comparison.

Results: The overall diagnostic accuracy for SMT was significantly higher in cases with than without ROSE (100% vs. 80%, p=0.03). The number of needle passes by FNA with ROSE by endosonographers tended to be fewer, although accuracy was increased (3.3¡¾1.3 vs. 5.9¡¾3.8, p=0.06).

Conclusions: ROSE by endosonographers during EUS-FNA for SMT is useful for definitive diagnosis, particularly for GIST.
KEYWORD
Endoscopic ultrasound-guided fine needle aspiration, Gastrointestinal stromal tumor, Endosonographer, On-site cytology
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