BACKGROUND: With the advent of immunohistochemical analysis, the term "gastrointestinal stromal tumor" (GIST) was proposed to designate the largest category of primary nonepithelial neoplasms. EUS-guided fine needle aspiration (EUS-FNA) is useful for diagnosis of GISTs. The aim of this study was to evaluate the phenotyping of GISTs and diagnosis of malignant GISTs by using EUS-FNA with immunohistochemical analysis. METHODS: A diagnosis of GIST was made in 23 patients by using EUS-FNA with immunohistochemical analysis. The accuracy of EUS-FNA diagnosis compared with the EUS imaging alone was analyzed. Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens was compared. Factors that were diagnostic for malignant GISTs were also analyzed. RESULTS: The overall accuracy for the diagnosis of malignant GIST was 78% (18/23) by EUS imaging alone and 91% (21/23) by histopathologic evaluation (H&E staining) of specimens obtained by EUS-FNA. In 21 of 23 cases (91%) the immunohistochemical expressions of c-kit, CD34, muscle actin, and S-100 coincided for the FNA and surgical specimens. The presence of mitotic cells (p = 0.011) and the Ki-67 labeling index (p < 0.0001) with respect to the FNA specimens were significant predictive factors for malignant GIST. For the diagnosis of malignant GIST, the accuracy, sensitivity, and specificity of EUS-FNA with the addition of Ki-67 immunohistochemical staining were 100%. CONCLUSIONS: EUS-FNA with immunohistochemical analysis is useful in the preoperative diagnosis of GIST. It provides abundant information on immunohistochemical subtyping and on the capacity of the tumor for cellular progression.
BACKGROUND: With the advent of immunohistochemical analysis, the term "gastrointestinal stromal tumor" (GIST) was proposed to designate the largest category of primary nonepithelial neoplasms. EUS-guided fine needle aspiration (EUS-FNA) is useful for diagnosis of GISTs. The aim of this study was to evaluate the phenotyping of GISTs and diagnosis of malignant GISTs by using EUS-FNA with immunohistochemical analysis. METHODS: A diagnosis of GIST was made in 23 patients by using EUS-FNA with immunohistochemical analysis. The accuracy of EUS-FNA diagnosis compared with the EUS imaging alone was analyzed. Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens was compared. Factors that were diagnostic for malignant GISTs were also analyzed. RESULTS: The overall accuracy for the diagnosis of malignant GIST was 78% (18/23) by EUS imaging alone and 91% (21/23) by histopathologic evaluation (H&E staining) of specimens obtained by EUS-FNA. In 21 of 23 cases (91%) the immunohistochemical expressions of c-kit, CD34, muscle actin, and S-100 coincided for the FNA and surgical specimens. The presence of mitotic cells (p = 0.011) and the Ki-67 labeling index (p < 0.0001) with respect to the FNA specimens were significant predictive factors for malignant GIST. For the diagnosis of malignant GIST, the accuracy, sensitivity, and specificity of EUS-FNA with the addition of Ki-67 immunohistochemical staining were 100%. CONCLUSIONS: EUS-FNA with immunohistochemical analysis is useful in the preoperative diagnosis of GIST. It provides abundant information on immunohistochemical subtyping and on the capacity of the tumor for cellular progression.
Authors: John DeWitt; Robert E Emerson; Stuart Sherman; Mohammad Al-Haddad; Lee McHenry; Gregory A Cote; Julia K Leblanc Journal: Surg Endosc Date: 2010-12-24 Impact factor: 4.584
Authors: J Martin-Broto; V Martinez-Marín; C Serrano; N Hindi; J A López-Guerrero; R Ramos-Asensio; A Vallejo-Benítez; D Marcilla-Plaza; R González-Cámpora Journal: Clin Transl Oncol Date: 2016-12-09 Impact factor: 3.405