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Year : 2021  |  Volume : 10  |  Issue : 2  |  Page : 134-140

Utility of a 20G needle with a core trap in EUS-guided fine-needle biopsy for gastric submucosal tumors: A multicentric prospective trial

1 Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Higashiosaka, Japan
2 Department of Gastroenterology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
3 Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto; Department of Diagnostic Pathology, Japanese Red Cross Kyoto Daini Hospital, Osaka, Japan
4 Clinical Research Center, Kindai University Hospital, Osakasayama, Japan
5 Department of Gastroenterology, Osaka City General Hospital, Osaka, Japan
6 Department of Gastroenterology and Hepatology, Japanese Red Cross Osaka Hospital, Osaka, Japan
7 Department of Medicine, Division of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
8 Department of Internal Medicine, Division of Gastroenterology, Graduate School of Medicine, Kobe University, Kobe, Japan
9 Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
10 Third Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
11 Department of Gastroenterology, Bell Land General Hospital, Sakai, Japan
12 Department of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
13 Department of Gastroenterology and Hepatology, Graduate School of Medicine, Osaka University, Suita, Japan
14 Department of Surgical Pathology, Kyoto Prefectural University of Medicine; Department of Diagnostic Pathology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
15 Second Department of Internal Medicine, School of Medicine, Wakayama Medical University, Wakayama, Japan

Correspondence Address:
Dr. Ken Kamata
Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Higashiosaka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/EUS-D-20-00171

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Background and Objectives: Differential diagnosis to estimate the malignant potential of gastric submucosal tumor (g-SMT) is important for decision-making. This study evaluated the use of a 20G needle with a core trap for EUS-guided fine-needle biopsy (EUS-FNB) for g-SMT. Methods: This multicentric prospective trial was registered in the University Hospital Medical Information Network (UMIN000021410). Consecutive patients with g-SMT who presented at one of the nine Japanese Referral Centers between June 2017 and November 2018 were enrolled. All patients underwent EUS-FNB using a 20G needle with a core trap. Samples obtained with the first-needle pass were used for central pathological review. EUS-FNB was evaluated in terms of (i) technical success rate, (ii) adequacy for histological evaluation, (iii) rate of complications, (iv) accuracy for histological diagnosis of gastrointestinal stromal tumor (GIST), and (v) concordance between GIST mitotic index determined by EUS-FNB and after tumor resection. Results: The study included 52 patients. The technical success rate of EUS-FNB was 100%. The adequacy rate for histological evaluation was 90.4% (P < 0.001). There were no complications related to EUS-FNB. Of the 38/52 patients who underwent surgical resection, 36 were finally diagnosed with GIST. The sensitivity, specificity, and accuracy of EUS-FNB for the histological diagnosis of g-SMT were 80.6%, 100%, and 81.6%, respectively. The concordance rate between the mitotic index on EUS-FNB and that after analysis of the resected tumor was 89.7%. Conclusions: EUS-FNB using a 20G needle with a core trap is feasible, providing histological samples of sufficient quality for diagnosing g-SMT.

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