Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study
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Background/Aims: This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the uppergastrointestinal (UGI) tract. Methods: The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals betweenJanuary and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016. Results: UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions,1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8–74) months. SELs were most frequentlyfound in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients(28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The pro-portions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1–2 cm), 27% (2–3 cm), and 38% (≥3 cm). In gastricSELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs. Conclusions: The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed byEUS and clinical decisions without initial pathological confirmation.
Abstract
Background/Aims: This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the uppergastrointestinal (UGI) tract. Methods: The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals betweenJanuary and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016. Results: UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions,1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8–74) months. SELs were most frequentlyfound in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients(28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The pro-portions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1–2 cm), 27% (2–3 cm), and 38% (≥3 cm). In gastricSELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs. Conclusions: The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed byEUS and clinical decisions without initial pathological confirmation.
참고문헌 (25)
- Lee M, "Feasibility and diagnostic yield of endoscopic ultrasonography-guided fine needle biopsy with a new core biopsy needle device in patients with gastric subepithelial tumors", Medicine(Baltimore), 94, pp.e1622~ (2015)
- Kim GH, "Comparison of 22-gauge aspiration needle with 22-gauge biopsy needle in endoscopic ultrasonography-guided subepithelial tumor sampling", Scand J Gastroenterol, 49, pp.347~354 (2014)
- He G, "Feasibility of endoscopic submucosal dissection for upper gastrointestinal submucosal tumors treatment and value of endoscopic ultrasonography in pre-operation assess and post-operation follow-up : a prospective study of 224 cases in a single medical center", Surg Endosc, 30, pp.4206~4213 (2016)
- Standards of Practice Committee, "The role of endoscopy in subepithelial lesions of the GI tract", Gastrointest Endosc, 85, pp.1117~1132 (2017)
- Gao Z, "The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors", BMC Gastroenterol, 17, pp.8~ (2017)
- 유대곤, "한국인에서 흔한 위 상피하 종양들", Korean Journal of Helicobacter Upper Gastrointestinal Research, 22(1), pp.29~37 (2022), 대한상부위장관ㆍ헬리코박터학회[DOI]
- Lim YJ, "Clinical course of subepithelial lesions detected on upper gastrointestinal endoscopy", World J Gastroenterol, 16, pp.439~444 (2010)
- 이정훈, "한국인에서 위상피하 종양의 유병률에 대한 연구: 단일기관 경험", 대한소화기학회지, 66(5), pp.274~276 (2015), 대한소화기학회
- Sharzehi K, "AGA clinical practice update on management of subepithelial lesions encountered during routine endoscopy : expert review", Clin Gastroenterol Hepatol, 20, pp.2435~2443 (2022)
- Jeong Seop Moon, "Role of Endoscopic Ultrasonography in Guiding Treatment Plans for Upper Gastrointestinal Subepithelial Tumors", Clinical Endoscopy, 49(3), pp.220~225 (2016), 대한소화기내시경학회
- Sun Moon Kim, "Predictive Factors for Differentiating Gastrointestinal Stromal Tumors from Leiomyomas Based on Endoscopic Ultrasonography Findings in Patients with Gastric Subepithelial Tumors: A Multicenter Retrospective Study", Clinical Endoscopy, 54(6), pp.872~880 (2021), 대한소화기내시경학회[DOI]
- 방창석, "Endoscopic submucosal dissection of gastric subepithelial tumors: a systematic review and meta-analysis", The Korean Journal of Internal Medicine, 31(5), pp.860~871 (2016), 대한내과학회[DOI]
- Kim TW, "Endoscopic resection for duodenal subepithelial tumors : a single-center experience", Surg Endosc, 31, pp.1936~1946 (2017)
- Deprez PH, "Endoscopic management of subepithelial lesions including neuroendocrine neoplasms : European Society of Gastrointestinal Endoscopy(ESGE)Guideline", Endoscopy, 54, pp.412~429 (2022)
- 김미나, "Prediction of Risk of Malignancy of Gastrointestinal Stromal Tumors by Endoscopic Ultrasonography", Gut and Liver, 7(6), pp.642~647 (2013), 거트앤리버 소화기연관학회협의회
- 김성은, "위 상피하 종양의 자연경과", Korean Journal of Helicobacter Upper Gastrointestinal Research, 15(1), pp.1~8 (2015), 대한상부위장관ㆍ헬리코박터학회[DOI]
- Jin Woong Cho, "Current Guidelines in the Management of Upper Gastrointestinal Subepithelial Tumors", Clinical Endoscopy, 49(3), pp.235~240 (2016), 대한소화기내시경학회
- Zhang XC, "Diagnostic efficacy of endoscopic ultrasound-guided needle sampling for upper gastrointestinal subepithelial lesions : a meta-analysis", Surg Endosc, 30, pp.2431~2441 (2016)
- Pouw RE, "Endoscopic tissue sampling : Part 1 : Upper gastrointestinal and hepatopancreatobiliary tracts. European Society of Gastrointestinal Endoscopy(ESGE)Guideline", Endoscopy, 53, pp.1174~1188 (2021)
- Joon Seop Lee, "Comparison of diagnostic performances of slow-pull suction and standard suction in endoscopic ultrasound-guided fine needle biopsy for gastrointestinal subepithelial tumors", Clinical Endoscopy, 55(5), pp.637~644 (2022), 대한소화기내시경학회[DOI]
- Zaheer Nabi, "Submucosal endoscopy: the present and future", Clinical Endoscopy, 56(1), pp.23~37 (2023), 대한소화기내시경학회[DOI]
- Chen H, "Current status of endoscopic resection of gastric subepithelial tumors", Am J Gastroenterol, 114, pp.718~725 (2019)
- Lee HL, "Endoscopic histologic diagnosis of gastric GI submucosal tumors via the endoscopic submucosal dissection technique", Gastrointest Endosc, 74, pp.693~695 (2011)
- van Wanrooij RL, "Therapeutic endoscopic ultrasound : European Society of Gastrointestinal Endoscopy(ESGE)Technical Review", Endoscopy, 54, pp.310~332 (2022)
- Pimentel-Nunes P, "Endoscopic submucosal dissection for superficial gastrointestinal lesions : European Society of Gastrointestinal Endoscopy(ESGE)Guideline : Update 2022", Endoscopy, 54, pp.591~622 (2022)