Pathology Unit, Department of Medical and Surgical Sciences, University of Cantabria and IDIVAL Research Institute, Santander, Spain.
Radiodiagnosis Service, Marqués de Valdecilla University Hospital, Santander, Spain.
Diagn Cytopathol. 2020 Sep;48(9):833-839. doi: 10.1002/dc.24442. Epub 2020 May 13.
This study aims to evaluate the usefulness of endoscopic ultrasound-guided fine-needle aspiration cytology (EUS-FNAC) in the diagnosis of the gastric gastrointestinal stromal tumor (GIST).
We retrospectively investigated the efficacy and accuracy of EUS-FNAC in the diagnosis of gastric GIST. Cytological smears and cytoblock sections including immunohistochemistry and mutational studies from patients diagnosed as gastric GISTs were retrieved.
Thirty patients (mean age 68.8 years, range 32-88 years, Male:Female 1:1.7) were diagnosed by cytological and cytoblock study to have GIST. The size of tumors ranged from 1.6 to 25 cm (mean 6.0 cm). 7 (23%) cases were incidentally discovered. Location was: gastric body 13 (43.3%), fundus 8 (26.7%), antrum 7 (23.3%), cardia 2 (6.7%). The study of removed tumors was correlated with the cytological findings. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 75%, 100%, 100%, 46%, and 96%. There were no false-positive cases. The preoperative risk assessment of 27 cases with cytoblock were: none 3 (11.1%), very low 8 (29.6%), low 12 (44.4%), high 3 (11.1%), insufficient clinical data 1 (3.7%). The follow-up varied from 2 to 120 months (mean 46.7 months). Only 1 patient of the high-risk group died. The most frequent mutations found were those of c-KIT in exon 11.
Pathological diagnosis was based on a combination of cytological, histopathological, and immunohistochemical features. EUS-FNAC is a reliable, accurate, and safe method for the diagnosis of GIST. The cytoblock allows tumor risk classification and mutational study of the cases.
本研究旨在评估内镜超声引导下细针抽吸细胞学（EUS-FNAC）在诊断胃胃肠间质瘤（GIST）中的作用。
我们回顾性调查了 EUS-FNAC 在诊断胃 GIST 中的疗效和准确性。从诊断为胃 GIST 的患者中检索了细胞学涂片和细胞块切片，包括免疫组织化学和突变研究。
30 例患者（平均年龄 68.8 岁，范围 32-88 岁，男女比例 1:1.7）通过细胞学和细胞块研究诊断为 GIST。肿瘤大小从 1.6 至 25cm（平均 6.0cm）。7 例（23%）为偶然发现。位置：胃体 13 例（43.3%），胃底 8 例（26.7%），胃窦 7 例（23.3%），贲门 2 例（6.7%）。切除肿瘤的研究与细胞学发现相关。敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 75%、100%、100%、46%和 96%。无假阳性病例。27 例细胞块的术前风险评估为：无风险 3 例（11.1%），极低风险 8 例（29.6%），低风险 12 例（44.4%），高风险 3 例（11.1%），临床资料不足 1 例（3.7%）。随访时间为 2 至 120 个月（平均 46.7 个月）。仅 1 例高危组患者死亡。最常见的突变发生在 c-KIT 外显子 11。
病理诊断基于细胞学、组织病理学和免疫组织化学特征的结合。EUS-FNAC 是一种可靠、准确、安全的 GIST 诊断方法。细胞块允许对病例进行肿瘤风险分类和突变研究。
