Korean J Gastrointest Endosc > Volume 37(5); 2008 > Article
Korean Journal of Gastrointestinal Endoscopy 2008;37(5): 328-334.
위장관 간엽종양의 감별진단에서 초음파 내시경하 대형침 생검
서울대학교 의과대학 내과학교실, 간연구소
Endoscopic Ultrasonography-guided Tru-Cut Biopsy for Differential Diagnosis in the Gastrointestinal Mesenchymal Neoplasm
Hyoun Woo Kang, M.D., Joo Sung Kim, M.D., Sang Gyun Kim, M.D., Hae Yeon Kang, M.D., Hyun Chae Jung, M.D. and In Sung Song, M.D.
Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea

Risk assessment by mitotic count in the gastrointestinal stromal tumor (GIST), the most common mesenchymal neoplasm, is important. EUS-guided fine- needle aspiration cannot obtain sufficient tissue for determination of mitotic count, but An EUS-guided Tru-Cut biopsy (EUS-TCB) can. The aim of this study was to evaluate clinical role of EUS-TCB in differential diagnosis of mesenchymal neoplasm and risk assessment of GIST.
We prospectively enrolled 18 patients who were diagnosed with submucosal hypoechoic tumors, 2∼5 cm, in the muscular layer by EUS in Seoul National University Hospital from November, 2005, to July, 2007. The rates of adequate biopsy and possibility of risk assessment were evaluated.
EUS-TCB was performed in 16 patients. The median tumor size was 2.7 cm, and adequate diagnosis was possible in 8 patients. Tumor size in the adequate specimen group was larger than in the inadequate group (p=0.021). The number of needle passes was higher in the adequate specimen group (p=0.012). Risk assessment by mitotic count was possible in only one case.
EUS-TCB in the diagnosis and risk assessment of GIST was inadequate, in part because of insufficient operator experience and small tumors. Development of a new instrument is needed to obtain sufficient tissue. (Korean J Gastrointest Endosc 2008;37:328-334)
Key Words: Mesenchymal neoplasm, Gastrointestinal stromal tumor, EUS-guided Tru-Cut biopsy
주요어: 위장관 간엽 종양, 위장관 간질 종양, 초음파 내시경하 대형침 생검
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