Sandoh Kaori, Ishida Mitsuaki, Okano Kimiaki, Miyasaka Chika, Mori Shigeo, Tokuhara Mitsuo, Suzuki Ryou, Okazaki Takashi, Nakamura Naohiro, Tsuta Koji
Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan.
Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Diagn Cytopathol. 2019 Sep;47(9):869-875. doi: 10.1002/dc.24252. Epub 2019 Jun 14.
Recently, there have been reports of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology being used for the diagnosis of various kinds of tumors. This method has also been adopted in the diagnosis of gastric submucosal tumors (SMTs). The aim of this study was to analyze the utility of EUS-FNA cytological examination in rapid on-site evaluation (ROSE) for gastric SMTs.
Retrospective analyses of the cytological specimens of EUS-FNA in ROSE for gastric SMTs and determination of the diagnostic accuracy of EUS-FNA combined with immunohistochemical analysis of cell blocks and surgically resected specimens were performed.
A total of 110 patients were enrolled in this study. The most common cytodiagnosis was spindle cell tumor (62 patients, 55.5%), followed by negative for tumor (34 patients), and malignant lymphoma and adenocarcinoma (five patients each). Cell blocks were prepared for 60 of the patients (96.8%), cytologically diagnosed with spindle cell tumor. Immunohistochemical analyses using cell block revealed gastrointestinal stromal tumor (GIST, c-kit /desmin , 49 patients) and leiomyoma (desmin /c-kit , five patients). Thus, using EUS-FNA specimens, 83.1% of GIST patients were pre-operatively diagnosed.
EUS-FNA cytological examination in ROSE for gastric SMTs aided in the collection of sufficient amounts of tumor tissues for preparing cell blocks. This method led to a high rate of accurate pre-operative diagnosis in patients with gastric SMTs.
最近，有报道称内镜超声引导下细针穿刺抽吸（EUS - FNA）细胞学检查可用于诊断各种肿瘤。该方法也已应用于胃黏膜下肿瘤（SMT）的诊断。本研究的目的是分析EUS - FNA细胞学检查在胃SMT快速现场评估（ROSE）中的效用。
对胃SMT的ROSE中EUS - FNA的细胞学标本进行回顾性分析，并确定EUS - FNA联合细胞块免疫组化分析及手术切除标本的诊断准确性。
本研究共纳入110例患者。最常见的细胞诊断为梭形细胞瘤（62例，55.5%），其次为肿瘤阴性（34例），以及恶性淋巴瘤和腺癌（各5例）。60例（96.8%）细胞学诊断为梭形细胞瘤的患者制备了细胞块。利用细胞块进行免疫组化分析显示为胃肠道间质瘤（GIST，c - kit /结蛋白 ，49例）和平滑肌瘤（结蛋白 /c - kit ，5例）。因此，使用EUS - FNA标本，83.1%的GIST患者得到了术前诊断。
胃SMT的ROSE中EUS - FNA细胞学检查有助于收集足够量的肿瘤组织以制备细胞块。该方法使胃SMT患者术前诊断准确率较高。
