• Something wrong with this record ?

Endosonography-Guided Fine-Needle Aspiration versus "Key-Hole Biopsy" in the diagnostics of upper gastrointestinal subepithelial tumors. A prospective randomized interventional study

V. Zoundjiekpon, P. Falt, P. Fojtik, E. Kundratova, O. Mikolajek, M. Hanousek, K. Reiterova, D. Ziak, M. Bolek, A. Tchibozo, M. Kliment, O. Urban

. 2020 ; 164 (1) : 63-70. [pub] 20190417

Language English Country Czech Republic

Document type Comparative Study, Journal Article, Randomized Controlled Trial

Persistent link   https://www.medvik.cz/link/bmc21006946

BACKGROUND: The management and prognosis of subepithelial tumors (SETs) of the upper gastrointestinal tract depend on the correct preoperative evaluation, including tissue diagnosis in selected cases. Several methods providing deep tissue sampling for cytological and/or histological examinations have been described but their diagnostic yield and precise position in the diagnostic algorithm remain to be established. This prospective randomized study aims to compare the Endosonography-Guided Fine-Needle Aspiration (EUS-FNA) to Key-Hole Biopsy (KHB) in cytological or histological diagnostics of upper gastrointestinal SETs. PATIENTS AND METHODS: This study was conducted in a single tertiary endoscopy center in Ostrava, Czech Republic between November 2010 and October 2015. Patients with endoscopically detected SETs of the upper gastrointestinal tract with a diameter ≥ 2 cm, were randomized to either the EUS-FNA with 22G needle, or to the Key Hole biopsy (forceps biopsy through mucosal incision) groups. The main study outcomes were success rate of tissue diagnostics and, in the cases of Gastrointestinal Stromal Tumours (GIST), possibility of determining mitotic activity. A cross-over examination was performed in situations where the first method had failed. RESULTS: A total of 46 consecutive patients were randomized. Of these, 24 (52%) and 22 (48%) were randomized to EUS-FNA group and KHB arm, respectively. 5 SETs (11%) were detected in the esophagus, 40 (87%) in the stomach and 1 (2%) in the duodenum. The definitive diagnosis was established by the first sampling method in 42 (91%) patients, including 22 (92%) in the EUS-FNA group and 20 (91%) in the KHB group (P=0.999), and after a cross-over in another 3 (7%) patients. The most prevalent SET was GIST (70%). Although some mitotic activity could be observed in 11 patients, the mitotic index could be diagnosed in none of them. Of a total of 20 surgically treated patients, preoperative and postoperative tissue diagnosis corresponded in 19/20 (95%) cases, including 100% in FNA group and 91% in KHB group (P=0.999). No adverse events of tissue sampling occurred in the study. CONCLUSIONS: Deep tissue sampling by EUS-FNA and KHB are equally effective in the diagnostics of SETs of the upper gastrointestinal tract ≥ 2 cm. However, neither EUS-FNA nor KHB provided adequate tissue sample to determine mitotic index. TRIAL REGISTRATION: Clinicaltrials.gov (NCT02025244).

References provided by Crossref.org

Bibliography, etc.

Literatura

000      
00000naa a2200000 a 4500
001      
bmc21006946
003      
CZ-PrNML
005      
20210503123842.0
007      
ta
008      
210309s2020 xr a f 000 0|eng||
009      
AR
024    7_
$a 10.5507/bp.2019.013 $2 doi
035    __
$a (PubMed)31025658
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xr
100    1_
$a Zoundjiekpon, Vincent $7 xx0224379 $u Department of Internal Medicine II - Gastroenterology and Geriatric, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic; Digestive Diseases Center, Vitkovice Hospital, Ostrava, Czech Republic
245    10
$a Endosonography-Guided Fine-Needle Aspiration versus "Key-Hole Biopsy" in the diagnostics of upper gastrointestinal subepithelial tumors. A prospective randomized interventional study / $c V. Zoundjiekpon, P. Falt, P. Fojtik, E. Kundratova, O. Mikolajek, M. Hanousek, K. Reiterova, D. Ziak, M. Bolek, A. Tchibozo, M. Kliment, O. Urban
504    __
$a Literatura
520    9_
$a BACKGROUND: The management and prognosis of subepithelial tumors (SETs) of the upper gastrointestinal tract depend on the correct preoperative evaluation, including tissue diagnosis in selected cases. Several methods providing deep tissue sampling for cytological and/or histological examinations have been described but their diagnostic yield and precise position in the diagnostic algorithm remain to be established. This prospective randomized study aims to compare the Endosonography-Guided Fine-Needle Aspiration (EUS-FNA) to Key-Hole Biopsy (KHB) in cytological or histological diagnostics of upper gastrointestinal SETs. PATIENTS AND METHODS: This study was conducted in a single tertiary endoscopy center in Ostrava, Czech Republic between November 2010 and October 2015. Patients with endoscopically detected SETs of the upper gastrointestinal tract with a diameter ≥ 2 cm, were randomized to either the EUS-FNA with 22G needle, or to the Key Hole biopsy (forceps biopsy through mucosal incision) groups. The main study outcomes were success rate of tissue diagnostics and, in the cases of Gastrointestinal Stromal Tumours (GIST), possibility of determining mitotic activity. A cross-over examination was performed in situations where the first method had failed. RESULTS: A total of 46 consecutive patients were randomized. Of these, 24 (52%) and 22 (48%) were randomized to EUS-FNA group and KHB arm, respectively. 5 SETs (11%) were detected in the esophagus, 40 (87%) in the stomach and 1 (2%) in the duodenum. The definitive diagnosis was established by the first sampling method in 42 (91%) patients, including 22 (92%) in the EUS-FNA group and 20 (91%) in the KHB group (P=0.999), and after a cross-over in another 3 (7%) patients. The most prevalent SET was GIST (70%). Although some mitotic activity could be observed in 11 patients, the mitotic index could be diagnosed in none of them. Of a total of 20 surgically treated patients, preoperative and postoperative tissue diagnosis corresponded in 19/20 (95%) cases, including 100% in FNA group and 91% in KHB group (P=0.999). No adverse events of tissue sampling occurred in the study. CONCLUSIONS: Deep tissue sampling by EUS-FNA and KHB are equally effective in the diagnostics of SETs of the upper gastrointestinal tract ≥ 2 cm. However, neither EUS-FNA nor KHB provided adequate tissue sample to determine mitotic index. TRIAL REGISTRATION: Clinicaltrials.gov (NCT02025244).
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    12
$a biopsie tenkou jehlou pod endosonografickou kontrolou $7 D061765
650    12
$a endosonografie $7 D019160
650    _2
$a studie proveditelnosti $7 D005240
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a gastrointestinální nádory $x diagnostické zobrazování $x patologie $7 D005770
650    _2
$a gastrointestinální stromální tumory $x diagnostické zobrazování $x patologie $7 D046152
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a mitotický index $7 D008940
650    _2
$a prospektivní studie $7 D011446
651    _2
$a Česká republika $7 D018153
655    _2
$a srovnávací studie $7 D003160
655    _2
$a časopisecké články $7 D016428
655    _2
$a randomizované kontrolované studie $7 D016449
700    1_
$a Falt, Přemysl, $d 1981- $7 xx0149631 $u Department of Internal Medicine II - Gastroenterology and Geriatric, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic; Faculty of Medicine, Charles University in Hradec Kralove, Czech Republic
700    1_
$a Fojtík, Petr $7 xx0105601 $u Digestive Diseases Center, Vitkovice Hospital, Ostrava, Czech Republic
700    1_
$a Kundrátová, Eva $7 xx0259326 $u Digestive Diseases Center, Vitkovice Hospital, Ostrava, Czech Republic
700    1_
$a Mikolajek, Otto $7 xx0259329 $u Digestive Diseases Center, Vitkovice Hospital, Ostrava, Czech Republic
700    1_
$a Hanousek, Martin $7 xx0258702 $u Digestive Diseases Center, Vitkovice Hospital, Ostrava, Czech Republic
700    1_
$a Reiterová, Kateřina $7 xx0259254 $u Biopsy and Cytology Department, Agel Laboratories, Novy Jicin, Czech Republic
700    1_
$a Žiak, Dušan $7 xx0207152 $u CGB Laboratories, Ostrava, Czech Republic
700    1_
$a Bolek, Martin $7 xx0087794 $u Department of Surgery, Vitkovice Hospital, Ostrava, Czech Republic
700    1_
$a Tchibozo, Anicet $u StatMed- Health Analytics & Business Intelligence, Saint-Jean Sur Richelieu, Quebec, Canada
700    1_
$a Kliment, Martin $7 xx0101175 $u Department of Internal Medicine, Gastroenterology and Hepatology- Vivantes Clinic, Berlin, Germany
700    1_
$a Urban, Ondřej, $d 1965- $7 stk2008428564
773    0_
$w MED00012606 $t Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia $x 1213-8118 $g Roč. 164, č. 1 (2020), s. 63-70
856    41
$u https://pubmed.ncbi.nlm.nih.gov/31025658 $y Pubmed
910    __
$a ABA008 $b A 1502 $c 958 $y p $z 0
990    __
$a 20210309 $b ABA008
991    __
$a 20210408181228 $b ABA008
999    __
$a ok $b bmc $g 1648168 $s 1127284
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2020 $b 164 $c 1 $d 63-70 $e 20190417 $i 1213-8118 $m Biomedical papers of the Medical Faculty of the University Palacký, Olomouc Czech Republic $n Biomed. Pap. Fac. Med. Palacký Univ. Olomouc Czech Repub. (Print) $x MED00012606
LZP    __
$b NLK118 $a Pubmed-20210309

Find record

Citation metrics

Archiving options