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Diagnostic performance of endoscopic ultrasonography-guided fine-needle biopsy in upper gastrointestinal subepithelial tumors measuring 2–5 cm in size

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Abstract

Background

Subepithelial tumors (SETs) in the upper gastrointestinal (GI) tract are frequently discovered during upper endoscopy, and their management is determined based on size and histopathological diagnosis. We aimed to evaluate the diagnostic performance of endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) in upper GI SETs of 2–5 cm in size.

Methods

We included 63 patients who underwent EUS-FNB for upper GI SETs of 2–5 cm in size between January 2013 and February 2020. The diagnostic yield of EUS-FNB, ability of EUS-FNB in discriminating malignant from non-malignant lesions, and histopathological concordance between EUS-FNB specimens and resected specimens were evaluated.

Results

Successful acquisition of macroscopic tissue cores was possible in all 63 cases, and the diagnostic yield of EUS-FNB was 92.1% (58/63). The sensitivity, specificity, and accuracy of EUS-FNB in discriminating malignant from non-malignant lesions were 100% (95% confidence interval [CI] 85.3–100%), 87.8% (95% CI 79.9–87.8%), and 92.1% (95% CI 81.8–92.1%), respectively. Of the 26 SETs that were endoscopically or surgically resected after EUS-FNB, the histopathological concordance rate between the EUS-FNB specimens and resected specimens was 100% (24/24), except in two cases of inadequate results with EUS-FNB specimens.

Conclusion

EUS-FNB provides high diagnostic yield and high capability in discriminating malignant from non-malignant lesions in upper GI SETs of 2–5 cm in size.

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Authors and Affiliations

  1. Department of Internal Medicine, Pusan National University College of Medicine and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok‑ro, Seo‑Gu, Busan, 49241, Republic of Korea

    Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Dong Hoon Baek & Geun Am Song

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  1. Dong Chan Joo
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  2. Gwang Ha Kim
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  3. Moon Won Lee
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  4. Bong Eun Lee
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Contributions

GHK: conception and design of this work; DCJ and GHK: acquisition and interpretation of data, drafting this work; MWL, BEL, DHB, and GAS revising it critically for important intellectual content. All authors approve the manuscript in its current form for publication and agree to be accountable for all aspects of the work.

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Correspondence to Gwang Ha Kim.

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Disclosures

Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Dong Hoon Baek, Geun Am Song have no conflicts of interest or financial ties to disclose.

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Joo, D.C., Kim, G.H., Lee, M.W. et al. Diagnostic performance of endoscopic ultrasonography-guided fine-needle biopsy in upper gastrointestinal subepithelial tumors measuring 2–5 cm in size. Surg Endosc 36, 8060–8066 (2022). https://doi.org/10.1007/s00464-022-09243-5

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