| 위장관 간엽종양의 감별진단에서 초음파 내시경하 대형침 생검 |
| 강현우ㆍ김주성ㆍ김상균ㆍ강해연ㆍ정현채ㆍ송인성 |
| 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 |
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| Abstract |
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Background/Aims:
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.
Methods:
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.
Results:
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.
Conclusions:
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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