Since their introduction into the clinical practices in 1980s, techniques of endoscopic ultrasonography（EUS） have been rapidly developing and are now in widespread use in gastrointestinal oncology. Evolving from the...Since their introduction into the clinical practices in 1980s, techniques of endoscopic ultrasonography（EUS） have been rapidly developing and are now in widespread use in gastrointestinal oncology. Evolving from the classical option, EUS today has been much innovated with addition of a variety of novel ideation which makes it a powerful tool with encouraging duality for both diagnostic and therapeutic purposes. There is a dire need for physicians in this field to understand the status quo of EUS as related to the management and detection of gastrointestinal tumors, which is globally reviewed in this paper.展开更多
AIM: To evaluate the ultrasonog raphy (EUS) features of gastric gastrointestinal stromal tumors (GISTs) as compared with gastric leiomyomas and then to determine the EUS features that could predict malignant GISTs.MET...AIM: To evaluate the ultrasonog raphy (EUS) features of gastric gastrointestinal stromal tumors (GISTs) as compared with gastric leiomyomas and then to determine the EUS features that could predict malignant GISTs.METHODS: We evaluated the endoscopic EUS features in 53 patients with gastric mesenchymal tumors conf irmed by histopathologic diagnosis. The GISTs were classif ied into benign and malignant groups according to the histological risk classif ication.RESULTS: Immunohistochemical analyses demon-strated 7 leiomyomas and 46 GISTs. Inhomogenicity, hyperechogenic spots, a marginal halo and higher echogenicity as compared with the surrounding muscle layer appeared more frequently in the GISTs than in the leiomyomas (P < 0.05). The presence of at least two of these four features had a sensitivity of 89.1% and a specifi city of 85.7% for predicting GISTs. Except for tumor size and irregularity of the border, most of the EUS features were not helpful for predicting the malignant potential of GISTs. On multivariate analysis, only the maximal diameter of the GISTs was an independent predictor. The optimal size for predicting malignant GISTs was 35 mm. The sensitivity and specificity using this value were 92.3% and 78.8%, respectively.CONCLUSION: EUS may help to differentiate gastric GISTs from gastric leiomyomas. Once GISTs are suspected, surgery should be considered if the size is greater than 3.5 cm.展开更多
基金sponsored by the Key Clinical Specialty Discipline Construction Program of Fujian, P.R.Cthe Special Funds of Finance Department of Fujian Province (2012B013)
文摘Since their introduction into the clinical practices in 1980s, techniques of endoscopic ultrasonography（EUS） have been rapidly developing and are now in widespread use in gastrointestinal oncology. Evolving from the classical option, EUS today has been much innovated with addition of a variety of novel ideation which makes it a powerful tool with encouraging duality for both diagnostic and therapeutic purposes. There is a dire need for physicians in this field to understand the status quo of EUS as related to the management and detection of gastrointestinal tumors, which is globally reviewed in this paper.
基金Supported by A Medical Research Institute Grant (2008-1)Pusan National University and a grant from the National R&D Program for Cancer Control, Ministry for Health, Welfare and Family affairs, Republic of Korea (0920050)
文摘AIM: To evaluate the ultrasonog raphy (EUS) features of gastric gastrointestinal stromal tumors (GISTs) as compared with gastric leiomyomas and then to determine the EUS features that could predict malignant GISTs.METHODS: We evaluated the endoscopic EUS features in 53 patients with gastric mesenchymal tumors conf irmed by histopathologic diagnosis. The GISTs were classif ied into benign and malignant groups according to the histological risk classif ication.RESULTS: Immunohistochemical analyses demon-strated 7 leiomyomas and 46 GISTs. Inhomogenicity, hyperechogenic spots, a marginal halo and higher echogenicity as compared with the surrounding muscle layer appeared more frequently in the GISTs than in the leiomyomas (P < 0.05). The presence of at least two of these four features had a sensitivity of 89.1% and a specifi city of 85.7% for predicting GISTs. Except for tumor size and irregularity of the border, most of the EUS features were not helpful for predicting the malignant potential of GISTs. On multivariate analysis, only the maximal diameter of the GISTs was an independent predictor. The optimal size for predicting malignant GISTs was 35 mm. The sensitivity and specificity using this value were 92.3% and 78.8%, respectively.CONCLUSION: EUS may help to differentiate gastric GISTs from gastric leiomyomas. Once GISTs are suspected, surgery should be considered if the size is greater than 3.5 cm.
