Yield of tissue sampling for subepithelial lesions evaluated by EUS: a comparison between forceps biopsies and endoscopic submucosal resection

Cantor, Michael J.; Davila, Raquel E.; Faigel, Douglas O.

doi:10.1016/j.gie.2006.02.027

Cited by 123 publications

(102 citation statements)

References 29 publications

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“…If a lesion, based on EUS criteria, seems to carry a low malignant potential, tissue samples must be obtained. However, a previous study showing that the image of a SET measured only by EUS without obtaining tissue samples is insufficient to establish the correct histological diagnosis in some conditions (1,5,10) . In our study, presumptive diagnosis of EUS was failed in 19 of 73 cases (26%) when histology was available.…”

Section: Discussionmentioning

confidence: 99%

Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging

Ardengh

Vaiciunas

Kemp

et al. 2011

Arq. Gastroenterol.

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-Context -The identification of a bulging covered by normal epithelium is a common finding during an upper gastrointestinal endoscopy. Objective -To compare the endoscopic and endosonography findings in the differential diagnosis of the gastrointestinal bulging (subepithelial tumor or extrinsic compression). Method -Patients referred by endosonography with bulging of upper gastrointestinal tract were studied retrospectively. The size, location, consistency and presumptive diagnosis were recorded at time of endoscopy and endosonography. Endosonography-guided fine-needle aspiration was proposed in case of uncertain diagnose to increase diagnostic sensitivity. Results -One hundred seventy-six patients (93 women) and mean age 62.5 years (10-87). One hundred fifty-three had subepithelial tumor and 23 had extrinsic compression as a final diagnosis. Endosonography had sensitivity, specificity and accuracy higher than those found by endoscopy for both diagnosis subepithelial tumor and extrinsic compression. Endoscopy and endosonography showed poor concordance (K = 0.13) for subepithelial tumor diagnosis and unsuitable agreement for diagnosis in extrinsic compression (K = 0.01). The endosonography-guided fine-needle aspiration had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 75%, 72.4%, 80.5%, 65.6% and 74%, respectively. Conclusion -Endoscopy has high sensitivity and low specificity for subepithelial tumor and both are low for the extrinsic compression. Endoscopy is a good tool for diagnosis of the subepithelial tumors, but not to determine the cause of an extrinsic compression. The endosonography identifies the layer from which subepithelial tumor comes, obtain histological samples, and increasing the diagnostic accuracy.

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Section: Discussionmentioning

confidence: 99%

Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging

Ardengh

Vaiciunas

Kemp

et al. 2011

Arq. Gastroenterol.

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“…19,20 In a study comparing jumbo forceps biopsy to endoscopic submucosal resection, the diagnostic yield of forceps biopsy was only 17% (vs. 87% for ESR, P = 0.001). 21 Device-assisted enteroscopy is now available to sample and mark tumours lying beyond the ligament of Treitz. GIST causing haematemesis or melena are usually found readily on upper endoscopy.…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Review article: the biology, diagnosis and management of gastrointestinal stromal tumours

Iorio

Sawaya

Friedenberg

2014

Aliment Pharmacol Ther

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SUMMARY BackgroundGastrointestinal stromal tumours (GIST) are the most common mesenchymal tumours of the gastrointestinal tract with an increasing incidence. AimsTo review the biology, diagnosis and treatment of gastrointestinal stromal tumours. MethodsA PubMed search using the phrases 'Gastrointestinal stromal tumor', 'imatinib', 'c-kit'. ResultsThe diagnosis of GIST is established by histology supplemented by the immunohistochemical marker CD117, which is positive in 95% of cases. The most common site of the tumour is the stomach. Most GIST are benign with 20-30% malignant. Five-year survival for malignant GIST ranges between 35% and 65% and depends primarily on tumour size, mitotic index and location. The malignant behaviour of GIST is best assessed by invasion of adjacent structures and distant metastases. The gold standard for treatment is surgical resection. Imatinib, a tyrosine kinase inhibitor, is the primary therapy for unresectable, recurrent or metastatic disease. ConclusionsGastrointestinal stromal tumours are rare tumours of the gastrointestinal tract and they vary in presentation. When surgical resection is not achievable, imatinib is the treatment of choice.

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“…Due to their submucosal or intramural location, however, they usually cannot be verified histologically by routine biopsies of the superficial normal mucosa. Endoscopic submucosal resection (ESMR) might be a procedure for diagnosing the very few, early gastric GIST that are confined to the mucosa and submucosa [7] . No reports are available on ESMR or endoscopic mucosal resection (EMR) for early gastric GIST [8] .…”

Section: Endoscopymentioning

confidence: 99%

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

Scherübl

Faiss

Knoefel

et al. 2014

WJGE

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Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. Approximately two thirds of clinically manifest tumors occur in the stomach, nearly one third in the small bowel, and the rest in the colorectal region with a few cases in the esophagus. GIST originate within the smooth muscle layer in the wall of the tubular gastrointestinal tract and grow mostly toward the serosa, far less often toward the mucosa. In the latter case, ulceration may develop and can cause gastrointestinal bleeding as the cardinal symptom. However, most GIST of the stomach are asymptomatic. They are increasingly detected incidentally as small intramural or submucosal tumors during endoscopy and particularly during endoscopic ultrasound. Epidemiological and molecular genetic findings suggest that early asymptomatic GIST of the stomach (< 1 cm) show self-limiting tumorigenesis. Thus, early (< 1 cm) asymptomatic gastric GIST (synonym: micro-GIST) are found in 20%-30% of the elderly. The mostly elderly people with early gastric GIST have an excellent GIST-specific prognosis. Patients with early GIST of the stomach can therefore be managed by endoscopic surveillance.

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Yield of tissue sampling for subepithelial lesions evaluated by EUS: a comparison between forceps biopsies and endoscopic submucosal resection

Cited by 123 publications

References 29 publications

Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging

Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging

Review article: the biology, diagnosis and management of gastrointestinal stromal tumours

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

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