Premium
CLINICAL MALIGNANCY RISK OF GIST ASSESSED BY ENDOSCOPIC ULTRASONOGRAPHY
Author(s) -
Ohashi Shinji,
Okamura Shozo,
Urano Fumihiro,
Maeda Matsuyoshi,
Goto Hidemi,
Niwa Yasumasa
Publication year - 2006
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2006.00652.x
Subject(s) - gist , medicine , asymptomatic , malignancy , radiology , pathological , endoscopic ultrasonography , stromal cell , pathology , gastroenterology , endoscopy
Background: The aim of the present study was to analyze clinicopathological findings in primary gastrointestinal stromal cell tumors (GIST) and to determine the clinical factors that indicate higher risk potential. Methods: Forty‐seven patients with primary GIST were enrolled, and their clinical, endosonographic ultrasonography (EUS), microscopic and immunohistochemical findings were evaluated. Risk categorization of GIST was made on histological tumor size and the mitotic rate. Results: EUS features (a larger diameter, an irregular border, and cystic areas) were significantly correlated with higher risk and unfavorable prognosis. Pathological features (tumor size > 50 mm, > 10 mitoses per 50 high‐power fields (HPF), necrosis, and high‐risk category) were significant unfavorable prognostic factors. However, some high‐risk GIST less than 50 mm in diameter did not have any cystic areas, an irregular border on EUS images. Among GIST that measured 50 mm or less on EUS, tumors with rapid growth and a change of internal echo (more inhomogeneity) were higher risk, while tumors that did not grow and showed no change of a homogeneous internal echo were lower risk. Conclusions: EUS parameters (a larger diameter, an irregular border, and cystic areas) indicate high‐risk potential. Tumor growth rate and change of internal echo pattern will be a helpful prognosticator, especially for asymptomatic and incidentally detected small GIST, where the classical EUS high‐risk parameters come up against limiting factors.