Clinical Endoscopy

  • 제57권1호
  • /
  • Pages.89-95
  • /
  • 2024
  • /
  • 2234-2400(pISSN)
  • /
  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지
DOI QR코드

DOI QR Code

Stereomicroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions

  • Seigo Nakatani (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Kosuke Okuwaki (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Masafumi Watanabe (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Hiroshi Imaizumi (Department of Gastroenterology, Japan Community Health Care Organization Sagamino Hospital) ;
  • Tomohisa Iwai (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Takaaki Matsumoto (Department of Gastroenterology, Isehara Kyodo Hospital) ;
  • Rikiya Hasegawa (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Hironori Masutani (Department of Gastroenterology, Japan Community Health Care Organization Sagamino Hospital) ;
  • Takahiro Kurosu (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Akihiro Tamaki (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Junro Ishizaki (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Ayana Ishizaki (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Mitsuhiro Kida (Department of Gastroenterology, Kitasato University School of Medicine) ;
  • Chika Kusano (Department of Gastroenterology, Kitasato University School of Medicine)
  • 투고 : 2022.10.18
  • 심사 : 2022.11.14
  • 발행 : 2024.01.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: In stereomicroscopic sample isolation processing, the cutoff value (≥4 mm) of stereomicroscopically visible white cores indicates high diagnostic sensitivity. We aimed to evaluate endoscopic ultrasound-guided tissue acquisition (EUS-TA) using a simplified stereomicroscopic on-site evaluation of upper gastrointestinal subepithelial lesions (SELs). Methods: In this multicenter prospective trial, we performed EUS-TA using a 22-gauge Franseen needle in 34 participants with SELs derived from the upper gastrointestinal muscularis propria, requiring pathological diagnosis. The presence of stereomicroscopically visible white core (SVWC) in each specimen was assessed using stereomicroscopic on-site evaluation. The primary outcome was EUS-TA's diagnostic sensitivity with stereomicroscopic on-site evaluation based on the SVWC cutoff value (≥4 mm) for malignant upper gastrointestinal SELs. Results: The total number of punctures was 68; 61 specimens (89.7%) contained stereomicroscopically visible white cores ≥4 mm in size. The final diagnoses were gastrointestinal stromal tumor, leiomyoma, and schwannoma in 76.5%, 14.7%, and 8.8% of the cases, respectively. The sensitivity of EUS-TA with stereomicroscopic on-site evaluation based on the SVWC cutoff value for malignant SELs was 100%. The per-lesion accuracy of histological diagnosis reached the highest level (100%) at the second puncture. Conclusions: Stereomicroscopic on-site evaluation showed high diagnostic sensitivity and could be a new method for diagnosing upper gastrointestinal SELs using EUS-TA.

키워드

참고문헌

  1. Wang KX, Ben QW, Jin ZD, et al. Assessment of morbidity and mortality associated with EUS-guided FNA: a systematic review. Gastrointest Endosc 2011;73:283-290.  https://doi.org/10.1016/j.gie.2010.10.045
  2. Klapman JB, Logrono R, Dye CE, et al. Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol 2003;98:1289-1294.  https://doi.org/10.1111/j.1572-0241.2003.07472.x
  3. Hocke M, Topalidis T, Braden B, et al. "Clinical" cytology for endoscopists: a practical guide. Endosc Ultrasound 2017;6:83-89.  https://doi.org/10.4103/eus.eus_21_17
  4. Lopes CV, Dedavid E, Silva TL, et al. The value of endoscopic ultrasound-fine needle aspiration in the suspicion of pancreatic hydatid cyst in endemic areas with negative serology (with video). Endosc Ultrasound 2017;6:350-351.  https://doi.org/10.4103/eus.eus_12_17
  5. Wang Y, Chai N, Feng J, et al. A prospective study of endoscopic ultrasonography features, cyst fluid carcinoembryonic antigen, and fluid cytology for the differentiation of small pancreatic cystic neoplasms. Endosc Ultrasound 2018;7:335-342.  https://doi.org/10.4103/eus.eus_40_17
  6. Biermann K, Lozano Escario MD, Hebert-Magee S, et al. How to prepare, handle, read, and improve EUS-FNA and fine-needle biopsy for solid pancreatic lesions: the pathologist's role. Endosc Ultrasound 2017;6(Suppl 3):S95-S98.  https://doi.org/10.4103/eus.eus_71_17
  7. van Riet PA, Cahen DL, Poley JW, et al. Mapping international practice patterns in EUS-guided tissue sampling: outcome of a global survey. Endosc Int Open 2016;4:E360-E370.  https://doi.org/10.1055/s-0042-101023
  8. Masutani H, Okuwaki K, Kida M, et al. On-site stereomicroscope quality evaluations to estimate white core cutoff lengths using EUS-FNA biopsy sampling with 22-gauge needles. Gastrointest Endosc 2019;90:947-956.  https://doi.org/10.1016/j.gie.2019.08.033
  9. Okuwaki K, Masutani H, Kida M, et al. Diagnostic efficacy of white core cutoff lengths obtained by EUS-guided fine-needle biopsy using a novel 22G Franseen biopsy needle and sample isolation processing by stereomicroscopy for subepithelial lesions. Endosc Ultrasound 2020;9:187-192.  https://doi.org/10.4103/eus.eus_18_20
  10. Okuwaki K, Imaizumi H, Kida M, et al. Usefulness of the automated multiband imaging system for EUS-FNA biopsy specimen evaluation in patients with upper gastrointestinal subepithelial lesions. Endosc Ultrasound 2022;11:283-290.  https://doi.org/10.4103/EUS-D-21-00143
  11. Watanabe M, Okuwaki K, Kida M, et al. Multicenter prospective study of the efficacy of stereomicroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition in patients with pancreatic cancer. Pancreatology 2022;22:311-316.  https://doi.org/10.1016/j.pan.2021.12.011
  12. Cotton PB, Eisen GM, Aabakken L, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010;71:446-454.  https://doi.org/10.1016/j.gie.2009.10.027
  13. Kida M, Kawaguchi Y, Miyata E, et al. Endoscopic ultrasonography diagnosis of subepithelial lesions. Dig Endosc 2017;29:431-443.  https://doi.org/10.1111/den.12854
  14. Polkowski M. Endoscopic ultrasound and endoscopic ultrasound-guided fine-needle biopsy for the diagnosis of malignant submucosal tumors. Endoscopy 2005;37:635-645.  https://doi.org/10.1055/s-2005-861422
  15. Goettsch WG, Bos SD, Breekveldt-Postma N, et al. Incidence of gastrointestinal stromal tumours is underestimated: results of a nation-wide study. Eur J Cancer 2005;41:2868-2872.  https://doi.org/10.1016/j.ejca.2005.09.009
  16. Ishigaki K, Nakai Y, Oyama H, et al. Endoscopic ultrasound-guided tissue acquisition by 22-gauge Franseen and standard needles for solid pancreatic lesions. Gut Liver 2020;14:817-825.  https://doi.org/10.5009/gnl19171
  17. Hedenstrom P, Marschall HU, Nilsson B, et al. High clinical impact and diagnostic accuracy of EUS-guided biopsy sampling of subepithelial lesions: a prospective, comparative study. Surg Endosc 2018;32:1304-1313.  https://doi.org/10.1007/s00464-017-5808-2
  18. Bang JY, Hebert-Magee S, Navaneethan U, et al. Randomized trial comparing the Franseen and Fork-tip needles for EUS-guided fine-needle biopsy sampling of solid pancreatic mass lesions. Gastrointest Endosc 2018;87:1432-1438.  https://doi.org/10.1016/j.gie.2017.11.036
  19. Conti CB, Cereatti F, Grassia R. Endoscopic ultrasound-guided sampling of solid pancreatic masses: the fine needle aspiration or fine needle biopsy dilemma. Is the best needle yet to come? World J Gastrointest Endosc 2019;11:454-471.  https://doi.org/10.4253/wjge.v11.i8.454
  20. Hebert-Magee S, Bae S, Varadarajulu S, et al. The presence of a cytopathologist increases the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration cytology for pancreatic adenocarcinoma: a meta-analysis. Cytopathology 2013;24:159-171.  https://doi.org/10.1111/cyt.12071
  21. Matynia AP, Schmidt RL, Barraza G, et al. Impact of rapid onsite evaluation on the adequacy of endoscopic-ultrasound guided fine-needle aspiration of solid pancreatic lesions: a systematic review and meta-analysis. J Gastroenterol Hepatol 2014;29:697-705.  https://doi.org/10.1111/jgh.12431
  22. Hewitt MJ, McPhail MJ, Possamai L, et al. EUS-guided FNA for diagnosis of solid pancreatic neoplasms: a meta-analysis. Gastrointest Endosc 2012;75:319-331.  https://doi.org/10.1016/j.gie.2011.08.049
  23. Kong F, Zhu J, Kong X, et al. Rapid on-site evaluation does not improve endoscopic ultrasound-guided fine needle aspiration adequacy in pancreatic masses: a meta-analysis and systematic review. PLoS One 2016;11:e0163056. 
  24. Polkowski M, Jenssen C, Kaye P, et al. Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) technical guideline: March 2017. Endoscopy 2017;49:989-1006.  https://doi.org/10.1055/s-0043-119219
  25. Yang F, Liu E, Sun S. Rapid on-site evaluation (ROSE) with EUS-FNA: the ROSE looks beautiful. Endosc Ultrasound 2019;8:283-287. https://doi.org/10.4103/eus.eus_65_19