Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?

查看全文 作　　者：Gwang Ha [1]Kim;Do Youn [2]Park;Suk [3]Kim;Dae Hwan [4]Kim;Dong Heon [4]Kim;Cheol Woong [1]Choi;Jeong [1]Heo;Geun Am [1]Song

机构地区：[1]Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital,Busan 602-739, South Korea;[2]Department of Pathology, Pusan National University School of Medicine,Busan 602-739, South Korea;[3]Department of Radiology, Pusan National University School of Medicine,Busan 602-739, South Korea;[4]Department of Surgery,Pusan National University School of Medicine,Busan 602-739,South Korea

出　　处：《World Journal of Gastroenterology》索引2009年第15卷第27期,共6页

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) 摘　　要：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. 关键词：胃肠道平滑肌内镜超声病理诊断多变量分析风险分类化学分析

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Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?

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