Monday abstract
Mo1469 The Usefulness of Endoscopic Ultrasonography-Guided Fine Needle Aspiration Biopsy for Gastric Subepithelial Lesion

https://doi.org/10.1016/j.gie.2015.03.1633Get rights and content

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Aim

The usefulness of endoscopic ultrasonography-guided fine needle aspiration biopsy (EUS-FNA) has been widely acknowledged for histopathological diagnosis of gastric subepithelial lesion (SEL). In Japan's consensus guidelines for the management of gastrointestinal stromal tumor (GIST), the adaptation standard of surgery and EUS-FNA for gastric SEL is indicated that tumor diameter is more than 20 mm. However, because GISTs have malignant potential and they are the most numerous among gastric SELs,

Method

This study examined 140 cases of gastric SELs for which EUS-FNA had been conducted during January 2001 - December 2013. We utilized mainly GF-UC260P or GF-UCT260 (Olympus), and various types of 22G or 19G FNA needles, for example NA-11J-KB (Olympus), EchoTip (Cook Medical) and Expect (Boston Scientific). We retrospectively examined the accuracy of EUS-FNA and prognosis after EUS-FNA.

Results

Participants comprised 68 men and 72 women, the average age was 61.0 years. The average number of punctures was 4.4 times (range 1-14), indicating no significant difference as tumor diameter. Rates of collected samples were 91.4% (128/140): 80% for smaller than 20 mm of tumor diameter (n=35), 94.9% for 20-50 mm (n=99), and 100% for larger than 50 mm (n=6). The EUS-FNA diagnoses were the following: GISTs were 95 cases; leiomyomas, 12; aberrant pancreas, 10; schwannomas, 2; gastric cancer, 1;

Conclusion

EUS-FNA for gastric SEL was useful to determine the course of treatment because of its high diagnostic accuracy and safety. Additionally, it is important to diagnose whether the lesion is GIST or not. It is possible to collect samples in 80%, even if they are smaller than 20 mm, which suggests that diagnosis can be established actively using EUS-FNA.

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