The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis

Nobuhiro Ando, Hidemi Goto, Yasumasa Niwa, Yoshiki Hirooka, Naoki Omiya, Tetsuo Nagasaka, Tetsuo Hayakawa

Research output: Contribution to journalArticle

302 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)37-43
Number of pages7
JournalGastrointestinal Endoscopy
Volume55
Issue number1
DOIs
Publication statusPublished - 01-01-2002
Externally publishedYes

Fingerprint

Fine Needle Biopsy
Gastrointestinal Stromal Tumors
Neoplasms
Staining and Labeling
Immunophenotyping
Actins
Sensitivity and Specificity
Muscles

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Ando, Nobuhiro ; Goto, Hidemi ; Niwa, Yasumasa ; Hirooka, Yoshiki ; Omiya, Naoki ; Nagasaka, Tetsuo ; Hayakawa, Tetsuo. / The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. In: Gastrointestinal Endoscopy. 2002 ; Vol. 55, No. 1. pp. 37-43.
@article{19667bba4bae4019973d07678507ae2d,
title = "The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis",
abstract = "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.",
author = "Nobuhiro Ando and Hidemi Goto and Yasumasa Niwa and Yoshiki Hirooka and Naoki Omiya and Tetsuo Nagasaka and Tetsuo Hayakawa",
year = "2002",
month = "1",
day = "1",
doi = "10.1067/mge.2002.120323",
language = "English",
volume = "55",
pages = "37--43",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "1",

}

The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. / Ando, Nobuhiro; Goto, Hidemi; Niwa, Yasumasa; Hirooka, Yoshiki; Omiya, Naoki; Nagasaka, Tetsuo; Hayakawa, Tetsuo.

In: Gastrointestinal Endoscopy, Vol. 55, No. 1, 01.01.2002, p. 37-43.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis

AU - Ando, Nobuhiro

AU - Goto, Hidemi

AU - Niwa, Yasumasa

AU - Hirooka, Yoshiki

AU - Omiya, Naoki

AU - Nagasaka, Tetsuo

AU - Hayakawa, Tetsuo

PY - 2002/1/1

Y1 - 2002/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0036134380&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036134380&partnerID=8YFLogxK

U2 - 10.1067/mge.2002.120323

DO - 10.1067/mge.2002.120323

M3 - Article

C2 - 11756912

AN - SCOPUS:0036134380

VL - 55

SP - 37

EP - 43

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 1

ER -