Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, South Korea.
Medicine (Baltimore). 2021 Jun 25;100(25):e26477. doi: 10.1097/MD.0000000000026477.
The diagnostic accuracy of endoscopic ultrasound-guided fine-needle tissue acquisition (EUS-FNTA) according to the gastric location of subepithelial tumors (SETs) has not been well established. We aimed to evaluate the efficacy of EUS-FNTA for the diagnosis of gastric SETs according to tumor location.Thirty-three patients diagnosed with gastric SETs via EUS-FNTA from January 2016 to May 2018 were analyzed retrospectively. Patient demographics, diagnostic yields, and complications were evaluated.Nineteen patients (57.6%) were female, with a mean age of 57.7 years. Endoscopic ultrasound revealed a mean longitudinal diameter of 25.6 mm. The most common location of SETs was in the gastric body (n = 18, 54.5%), followed by cardia and fundus (n = 10, 30.3%), and antrum (n = 5, 15.2%). A 20-gauge biopsy needle was most frequently used (90.9%). The diagnostic yield was obtained in 23 patients (69.7%). The most common diagnosis was gastrointestinal stromal tumor (73.9%), followed by leiomyoma (17.4%). The diagnostic yield of SETs in gastric antrum (0/5, 0%) was significantly lower than that in the gastric body and cardia (23/28, 82.1%, P = .001). A case of immediate bleeding after EUS-FNTA occurred in 1 patient (3.0%) who recovered uneventfully. According to related literature, the overall diagnostic yield of SETs in gastric antrum was significantly lower than that in the gastric body, fundus, and cardia (29.7% vs 71.4%, P < .001, n = 191).EUS-FNTA is ineffective in the diagnosis of SETs in the gastric antrum. Although EUS-FNTA is an advanced diagnostic tool for gastric SETs, it is essential to develop more effective methods for the diagnosis of antral SETs.
内镜超声引导下细针组织采集(EUS-FNTA)对胃黏膜下肿瘤(SETs)的诊断准确性尚未得到充分证实。本研究旨在评估根据肿瘤位置判断 EUS-FNTA 对胃 SETs 的诊断效果。
回顾性分析了 2016 年 1 月至 2018 年 5 月期间通过 EUS-FNTA 诊断为胃 SETs 的 33 例患者。评估了患者的人口统计学特征、诊断率和并发症。
19 例(57.6%)为女性,平均年龄为 57.7 岁。内镜超声显示 SETs 的平均纵向直径为 25.6mm。SETs 最常见的位置是胃体(18 例,54.5%),其次是贲门和胃底(10 例,30.3%),胃窦(5 例,15.2%)。最常使用 20G 活检针(90.9%)。23 例(69.7%)获得了诊断性标本。最常见的诊断是胃肠道间质瘤(73.9%),其次是平滑肌瘤(17.4%)。胃窦 SETs 的诊断率(0/5,0%)明显低于胃体和贲门(23/28,82.1%,P=0.001)。1 例(3.0%)患者在 EUS-FNTA 后立即出现出血,经治疗后恢复顺利。根据相关文献,胃窦 SETs 的总体诊断率明显低于胃体、胃底和贲门(29.7%比 71.4%,P<0.001,n=191)。
EUS-FNTA 对胃窦 SETs 的诊断效果不佳。虽然 EUS-FNTA 是一种先进的胃 SETs 诊断工具,但开发更有效的胃窦 SETs 诊断方法至关重要。