Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?

作     者：Gwang Ha Kim Do Youn Park Suk Kim Dae Hwan Kim Dong Heon Kim Cheol Woong Choi Jeong Heo Geun Am Song 

作者机构：Department of Internal Medicine Pusan National University School of Medicine and Medical Research Institute Pusan National University HospitalBusan 602-739 South Korea Department of Pathology Pusan National University School of MedicineBusan 602-739 South Korea Department of Radiology Pusan National University School of MedicineBusan 602-739 South Korea Department of SurgeryPusan National University School of MedicineBusan 602-739South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2009年第15卷第27期

页      面：3376-3381页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by A Medical Research Institute Grant (2008-1) Pusan National University and a grant from the National R&D Program for Cancer Control, Ministry for Health, Welfare and Family affairs, Republic of Korea (0920050) 

主　　题：Endoscopic ultrasonography, Gastrointestinal stromal tumor Stomach 

摘      要：AIM: To evaluate the ultrasonog raphy (EUS) features of gastric gastrointestinal stromal tumors (GISTs) as compared with gastric leiomyomas and then to determine the EUS features that could predict malignant ***: We evaluated the endoscopic EUS features in 53 patients with gastric mesenchymal tumors conf irmed by histopathologic diagnosis. The GISTs were classif ied into benign and malignant groups according to the histological risk classif ***: Immunohistochemical analyses demon-strated 7 leiomyomas and 46 GISTs. Inhomogenicity, hyperechogenic spots, a marginal halo and higher echogenicity as compared with the surrounding muscle layer appeared more frequently in the GISTs than in the leiomyomas (P 0.05). The presence of at least two of these four features had a sensitivity of 89.1% and a specifi city of 85.7% for predicting GISTs. Except for tumor size and irregularity of the border, most of the EUS features were not helpful for predicting the malignant potential of GISTs. On multivariate analysis, only the maximal diameter of the GISTs was an independent predictor. The optimal size for predicting malignant GISTs was 35 mm. The sensitivity and specificity using this value were 92.3% and 78.8%, ***: EUS may help to differentiate gastric GISTs from gastric leiomyomas. Once GISTs are suspected, surgery should be considered if the size is greater than 3.5 cm.