Diagnostic Yields of Endoscopic Ultrasound-Guided Fine-Needle Tissue Acquisition according to the Gastric Location

Abstract

AimThe histologic diagnosis of sub-epithelial tumors (SETs) in stomach has been achieved via endoscopic or surgical resection. We evaluated the efficacy of endoscopic ultrasound-guided fine-needle tissue acquisition (EUS-FNTA) for the diagnosis of gastric SETs according to the gastric location.MethodThirty-three patients diagnosed with gastric SETs via EUS-FNTA from January 2016 to May 2018 were analyzed retrospectively. Demographic characteristics, diagnostic yields and complications were evaluated.ResultsNineteen patients (57.6%) were female, with a median age of 57.7 years. EUS revealed a mean longitudinal diameter of 25.6 mm. The most common location of SETs was gastric body (n = 18, 54.5%), followed by cardia and fundus (n = 10, 30.3%), and antrum (n = 5, 15.2%). Twenty-gauge biopsy needle was used most frequently (90.9%). The diagnostic yield was obtained in 23 patients (69.7%). The most common diagnosis was gastrointestinal stromal tumor (69.5%), followed by leiomyoma (13.0%), and ectopic pancreas (8.7%). The diagnostic yield of SETs in gastric antrum (0/5, 0%) was significantly lower than in the gastric body and cardia (23/28, 82.1%, p = 0.001). A case of immediate bleeding after EUS-FNTA occurred in one patient (3.0%) who recovered uneventfully. According to studies reported in English literature, the overall diagnostic yield of SETs in gastric antrum was significantly lower than in the gastric body, fundus, and cardia (29.7% vs. 71.4%, p < 0.001, n = 191)ConclusionsAlthough EUS-FNTA is an advanced diagnostic tool for gastric SETs, it is essential to develop more effective methods for the diagnosis of antral SETs.