Koizumi Eriko, Goto Osamu, Nakagome Shun, Habu Tsugumi, Ishikawa Yumiko, Kirita Kumiko, Noda Hiroto, Higuchi Kazutoshi, Onda Takeshi, Akimoto Teppei, Omori Jun, Akimoto Naohiko, Iwakiri Katsuhiko
Department of Gastroenterology Nippon Medical School Graduate School of Medicine Tokyo Japan.
Division of Endoscopy Nippon Medical School Hospital Tokyo Japan.
DEN Open. 2023 Jun 22;4(1):e264. doi: 10.1002/deo2.264. eCollection 2024 Apr.
Mucosal incision-assisted biopsy (MIAB) has been introduced as an alternative to endoscopic ultrasound-guided fine needle aspiration for tissue sampling of subepithelial lesions. However, there have been few reports on MIAB, and the evidence is lacking, particularly in small lesions. In this case series, we investigated the technical outcomes and postprocedural influences of MIAB for gastric subepithelial lesions 10 mm or greater in size.
We retrospectively reviewed cases with the intraluminal growth type of possible gastrointestinal stromal tumors, in which MIAB was performed at a single institution between October 2020 and August 2022. Technical success, adverse events, and clinical courses following the procedure were evaluated.
In 48 MIAB cases with a median tumor diameter of 16 mm, the success rate of tissue sampling and the diagnostic rate were 96% and 92%, respectively. Two biopsies were considered sufficient for making the definitive diagnosis. Postoperative bleeding occurred in one case (2%). In 24 cases, surgery has performed a median of two months after MIAB, and no unfavorable findings caused by MIAB were seen intraoperatively. Finally, 23 cases were histologically diagnosed as gastrointestinal stromal tumors, and no patients who underwent MIAB experienced recurrence or metastasis during a median observation period of 13 months.
The data indicated that MIAB appears feasible, safe, and useful for histological diagnosis of gastric intraluminal growth types of possible gastrointestinal stromal tumors, even those of a small size. Postprocedural clinical effects were considered negligible.
黏膜切开辅助活检(MIAB)已被引入,作为内镜超声引导下细针穿刺抽吸术的替代方法,用于上皮下病变的组织采样。然而,关于MIAB的报道很少,证据不足,尤其是在小病变方面。在本病例系列中,我们研究了MIAB对大小为10毫米或更大的胃上皮下病变的技术结果和术后影响。
我们回顾性分析了2020年10月至2022年8月在单一机构进行MIAB的腔内生长型疑似胃肠道间质瘤病例。评估了手术的技术成功率、不良事件和术后临床过程。
在48例MIAB病例中,肿瘤中位直径为16毫米,组织采样成功率和诊断率分别为96%和92%。两次活检被认为足以做出明确诊断。1例(2%)发生术后出血。24例在MIAB后中位两个月进行了手术,术中未发现由MIAB引起的不良情况。最后,23例经组织学诊断为胃肠道间质瘤,在中位13个月的观察期内,接受MIAB的患者均未出现复发或转移。
数据表明,MIAB对于胃腔内生长型疑似胃肠道间质瘤,甚至小尺寸的此类肿瘤的组织学诊断似乎是可行、安全且有用的。术后临床影响可忽略不计。