Yosuke Minoda1,2, Eikichi Ihara3,4, Soichi Itaba5, Yorinobu Sumida6, Kazuhiro Haraguchi7, Akira Aso7, Takahiro Mizutani8, Takashi Osoegawa6, Mitsuru Esaki1, Shuzaburo Nagatomo1, Kei Nishioka1, Kazumasa Muta1,9, Xiaopeng Bai1, Haruei Ogino1, Nao Fujimori1, Daisuke Tsurumaru10, Kenoki Ohuchida11, Hu Qingjiang12, Eiji Oki12, Hidetaka Yamamoto13, Yoshihiro Ogawa1. 1. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan. 2. Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, Fukuoka, 812-8582, Japan. 3. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan. ihara.eikichi.167@m.kyushu-u.ac.jp. 4. Department of Gastroenterology and Metabolism, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. ihara.eikichi.167@m.kyushu-u.ac.jp. 5. Department of Gastroenterology, Kyushu Rosai Hospital, Kitakyushu, 800-0296, Japan. 6. Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, 810-8564, Japan. 7. Department of Gastroenterology, Harasanshin Hospital, Fukuoka, 812-0033, Japan. 8. Department of Gastroenterology, Kitakyushu Municipal Medical Center, Kitakyushu, 802-0077, Japan. 9. Department of Gastroenterology, Muta Hospital, Fukuoka, 814-0163, Japan. 10. Department of Clinical Radiology, Kyushu University, Fukuoka, 812-8582, Japan. 11. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan. 12. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan. 13. Department of Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
Abstract
BACKGROUND: Mucosal incision-assisted biopsy (MIAB) is a valuable alternative to endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNAB) for sampling gastric subepithelial lesions (SELs). This study aimed to evaluate the potential risk of dissemination and impact on postoperative prognosis associated with MIAB, which has not yet been investigated. METHODS: Study 1: A prospective observational study was conducted to examine the presence or absence and growth rate of tumor cells in gastric juice before and after the procedure in patients with SELs who underwent MIAB (n = 25) or EUS-FNAB (n = 22) between September 2018 and August 2021. Study 2: A retrospective study was conducted to examine the impact of MIAB on postoperative prognosis in 107 patients with gastrointestinal stromal tumors diagnosed using MIAB (n = 39) or EUS-FNAB (n = 68) who underwent surgery between January 2001 and July 2020. RESULTS: In study 1, although no tumor cells were observed in gastric juice in MIAB before the procedure, they were observed in 64% of patients after obtaining samples (P < 0.001). In contrast, no tumor cells were observed in the gastric juice in EUS-FNAB before and after the procedure. In study 2, there was no significant difference in 5-year disease-free survival between MIAB (100%) and EUS-FNAB (97.1%) (P = 0.27). CONCLUSION: MIAB is safe, with little impact on postoperative prognosis, although the procedure releases some tumor cells after damaging the SEL's pseudocapsule.
BACKGROUND: Mucosal incision-assisted biopsy (MIAB) is a valuable alternative to endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNAB) for sampling gastric subepithelial lesions (SELs). This study aimed to evaluate the potential risk of dissemination and impact on postoperative prognosis associated with MIAB, which has not yet been investigated. METHODS: Study 1: A prospective observational study was conducted to examine the presence or absence and growth rate of tumor cells in gastric juice before and after the procedure in patients with SELs who underwent MIAB (n = 25) or EUS-FNAB (n = 22) between September 2018 and August 2021. Study 2: A retrospective study was conducted to examine the impact of MIAB on postoperative prognosis in 107 patients with gastrointestinal stromal tumors diagnosed using MIAB (n = 39) or EUS-FNAB (n = 68) who underwent surgery between January 2001 and July 2020. RESULTS: In study 1, although no tumor cells were observed in gastric juice in MIAB before the procedure, they were observed in 64% of patients after obtaining samples (P < 0.001). In contrast, no tumor cells were observed in the gastric juice in EUS-FNAB before and after the procedure. In study 2, there was no significant difference in 5-year disease-free survival between MIAB (100%) and EUS-FNAB (97.1%) (P = 0.27). CONCLUSION: MIAB is safe, with little impact on postoperative prognosis, although the procedure releases some tumor cells after damaging the SEL's pseudocapsule.
Authors: J A Crosby; C N Catton; A Davis; J Couture; B O'Sullivan; R Kandel; C J Swallow Journal: Ann Surg Oncol Date: 2001 Jan-Feb Impact factor: 5.344
Authors: Diogo T H de Moura; Thomas R McCarty; Pichamol Jirapinyo; Igor B Ribeiro; Victor K Flumignan; Fedaa Najdawai; Marvin Ryou; Linda S Lee; Christopher C Thompson Journal: Gastrointest Endosc Date: 2020-02-25 Impact factor: 9.427