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Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy in Gastrointestinal Subepithelial Tumors

Do Hoon Kim|Gyu Young Pih
대한소화기내시경학회 (The Korean Society Of Gastrointestinal Endoscopy)|2019.07|Clinical Endoscopy|제52권 제4호|pp. 314-320|DOI 10.5946/ce.2019.100

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참고문헌

키워드

StomachEndoscopic ultrasoundSubepithelial tumor
주제분류내과학

초록

The incidence of asymptomatic and incidentally found upper gastrointestinal subepithelial tumors (SETs) is increasing with theimplementation of national cancer screening and the development of high-resolution endoscopy in Korea. However, endoscopy alonecannot be used to determine whether SETs are benign or malignant. Endoscopic ultrasound (EUS) is used to further characterize theselesions through the examination of their layered structure, internal echogenicity, size, and relationship to the extramural structure. Theseprovide additional information on whether the lesion is benign or malignant. Nevertheless, the sensitivity and specificity of EUS alonein predicting malignancy is unsatisfactory. Recent guidelines have recommended deciding the timing of EUS-fine needle aspiration andbiopsy (EUS-FNA/B) for SETs based on tumor size, malignant features on endoscopy, and high-risk features on EUS. The diagnosticaccuracy of EUS-FNA/B is reportedly influenced by factors including needle size, number of needle passes, use of suction, use of a styletin the needle assembly, fanning technique, availability of an on-site cytopathologist, and experience of the endosonographer. Therefore,according to the characteristics of the SETs, various subsequent methods and techniques should be appropriately employed to improvethe diagnostic yield of EUS-FNA/B.

Abstract

The incidence of asymptomatic and incidentally found upper gastrointestinal subepithelial tumors (SETs) is increasing with theimplementation of national cancer screening and the development of high-resolution endoscopy in Korea. However, endoscopy alonecannot be used to determine whether SETs are benign or malignant. Endoscopic ultrasound (EUS) is used to further characterize theselesions through the examination of their layered structure, internal echogenicity, size, and relationship to the extramural structure. Theseprovide additional information on whether the lesion is benign or malignant. Nevertheless, the sensitivity and specificity of EUS alonein predicting malignancy is unsatisfactory. Recent guidelines have recommended deciding the timing of EUS-fine needle aspiration andbiopsy (EUS-FNA/B) for SETs based on tumor size, malignant features on endoscopy, and high-risk features on EUS. The diagnosticaccuracy of EUS-FNA/B is reportedly influenced by factors including needle size, number of needle passes, use of suction, use of a styletin the needle assembly, fanning technique, availability of an on-site cytopathologist, and experience of the endosonographer. Therefore,according to the characteristics of the SETs, various subsequent methods and techniques should be appropriately employed to improvethe diagnostic yield of EUS-FNA/B.

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관련 논문AI추천

Comparison of diagnostic performances of slow-pull suction and standard suction in endoscopic ultrasound-guided fine needle biopsy for gastrointestinal subepithelial tumors서안나, Chang Min Cho, Han Ik Bae, Joon Seop Lee, Man-Hoon Han, Yong Hwan Kwon대한소화기내시경학회 · Clinical Endoscopy2022 · 제55권 제5호Yields and Utility of Endoscopic Ultrasonography-Guided 19-Gauge Trucut Biopsy versus 22-Gauge Fine Needle Aspiration김도훈, 김진호, 나희경, 박영수, 송호준, 안지영, 이정훈, 이진혁, 정훈용, 최귀숙, 최기돈대한소화기내시경학회 · Clinical Endoscopy2015 · 제48권 제2호Advances in the Management of Upper Gastrointestinal Subepithelial Tumor: Pathologic Diagnosis Using Endoscopy without Endoscopic Ultrasound-Guided BiopsyHang Lak Lee대한소화기내시경학회 · Clinical Endoscopy2016 · 제49권 제3호Endoscopic Ultrasound-Fine Needle Aspiration versus Core Biopsy for the Diagnosis of Subepithelial Tumors케빈 웹, 황주하대한소화기내시경학회 · Clinical Endoscopy2013 · 제46권 제5호Current Status of Endoscopic Ultrasonography in Gastrointestinal Subepithelial TumorsJi Hyun Song, Joo Ha Hwang, Sang Gyun Kim대한소화기내시경학회 · Clinical Endoscopy2019 · 제52권 제4호Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions김상우, 김진수, 문성진, 박은영, 박재명, 성혜정, 이인석, 임철현, 조유경, 최규영, 최명규대한소화기내시경학회 · Clinical Endoscopy2013 · 제46권 제6호

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