Department of Gastroenterology and Hepatology, International University of Health And Welfare Mita Hospital, Tokyo, Japan.
Dig Endosc. 2013 May;25(3):274-80. doi: 10.1111/j.1443-1661.2012.01384.x. Epub 2012 Nov 8.
The Japanese Gastrointestinal Stromal Tumor (GIST) therapeutic guidelines recommend endoscopic ultrasound-guided fine-needle aspiration biopsy for histological diagnosis. However, before 2010, this technique was only carried out at a minority of medical institutions in Japan. In the present study, we investigated the usefulness of mucosal cutting biopsy.
In 18 asymptomatic gastric submucosal tumors, mucosal cutting biopsies were carried out. We examined tumor size, tumor site (lower third: L; middle third: M; upper third: U), histopathological diagnostic yield and complications. In cases that proceeded to surgical resection with a diagnosis of GIST, we compared the pre- and postoperative histopathological diagnosis, and the histological degrees of malignancy.
The tumors had a mean size of 20.3 mm and were located at the L site in five cases, M in four, and U in nine. Histological diagnosis of submucosal tumor was obtained in all the cases. (GIST, n = 13; heterotopic pancreas, n = 2; and leiomyoma, n = 3). No complications (e.g. bleeding, perforation or peritonitis) were seen after this procedure. In all 11 patients with GIST who underwent surgical resection, the histopathological findings from the mucosal cutting biopsy specimens were similar to those from the surgically resected specimens, with agreement between the immunostaining findings and the histological degree of malignancy (90.9%) in 10 patients.
The mucosal cutting biopsy technique is a useful diagnostic modality for the diagnosis of gastric GIST and for selection of the appropriate treatment.
日本胃肠道间质瘤（GIST）治疗指南推荐内镜超声引导下细针抽吸活检进行组织学诊断。然而，在 2010 年之前，这项技术仅在日本少数医疗机构开展。本研究旨在探讨黏膜切开活检的实用性。
对 18 例无症状胃黏膜下肿瘤进行黏膜切开活检。我们检查了肿瘤大小、肿瘤部位（下 1/3：L；中 1/3：M；上 1/3：U）、组织病理学诊断率和并发症。对于诊断为 GIST 并进行手术切除的病例，我们比较了术前和术后的组织病理学诊断以及组织学恶性程度。
肿瘤平均大小为 20.3mm，位于 L 部位 5 例，M 部位 4 例，U 部位 9 例。所有病例均获得黏膜下肿瘤的组织学诊断。（GIST，n=13；异位胰腺，n=2；平滑肌瘤，n=3）。该操作后未见任何并发症（如出血、穿孔或腹膜炎）。在所有 11 例接受手术切除的 GIST 患者中，黏膜切开活检标本的组织病理学发现与手术切除标本相似，10 例患者的免疫组化结果与组织学恶性程度一致（90.9%）。
黏膜切开活检技术是诊断胃 GIST 并选择适当治疗方法的一种有用的诊断方法。
