Endoscopic ultrasound-guided fine needle tissue acquisition biopsy samples do not allow a reliable proliferation assessment of gastrointestinal stromal tumours. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Ricci, Riccardo; Chiarello, Gaia; Attili, Fabia; Fuccio, Lorenzo; Alfieri, Sergio; Persiani, Roberto; Di Pietro, Salvatore; Martini, Maurizio; Costamagna, Guido; Larocca, Luigi M.; Larghi, Alberto
• Is Part Of: Digestive and liver disease. Volume 47:Issue 4(2015)
• Page Start: 291
• Page End: 295
• Publication Date: 2015-04
• Subjects: Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2014.12.011
• Languages: English
• ISSNs: 1590-8658

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Background</title> <p id="spar0005">Current prognostication of gastrointestinal stromal tumours is validated on/applies to resected tumours, mainly because surgery is recommended whenever possible. However, pre-treatment prognostication is increasingly warranted, considering the follow-up strategy recently admitted for expectedly low-risk tumours and the possible distinctive molecular features/spontaneous regression of some small cases.</p> </sec> <sec> <title id="sect0015">Aims</title> <p id="spar0010">To investigate whether endoscopic ultrasound-guided fine-needle tissue acquisition-biopsies reflect prognosticators of resected gastrointestinal stromal tumours, for possibly developing reliable pre-treatment prognostic criteria.</p> </sec> <sec> <title id="sect0020">Methods</title> <p id="spar0015">The applicability/reliability of mitotic index/5 mm<sup>2</sup> and MIB1 proliferative index/1000 cells were tested in 35 endoscopic ultrasound-guided fine-needle tissue acquisition-biopsies diagnosed as gastrointestinal stromal tumour, subsequently resected without intervening therapy, consecutively collected in thirty months. Size and mitotic/proliferative indexes were compared with resection specimens. The feasibility of bioptic genotyping was also tested.</p> </sec> <sec> <title id="sect0025">Results</title> <p id="spar0020">35 patients were studied (45.7% males; mean age 61.6 years, range 26–83 years). Mitotic/proliferative indexes were determinable in 68.6%/88.6% of biopsies, respectively; they were nevertheless underestimated, as happened with endoscopic ultrasound-determined tumour size. Bioptic genotyping revealed reliable.</p> </sec> <sec> <title id="sect0030">Conclusions</title> <p id="spar0025">Endoscopic ultrasound-guided fine-needle tissue acquisition does not reliably reflect gastrointestinal stromal tumours' proliferation and size. Alternative parameters should be validated for a pre-surgical prognostic classification. Considering the emerging potentially prognostic genetic markers in gastrointestinal stromal tumours, the reliability of bioptic genotyping is a promising result.</p> </sec> </abstract>