The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis

Ando, Nobuhiro; Goto, Hidemi; Niwa, Yasumasa; Hirooka, Yoshiki; Ohmiya, Naoki; Nagasaka, Tetsuo; Hayakawa, Tetsuo

doi:10.1067/mge.2002.120323

Cited by 317 publications

(286 citation statements)

References 27 publications

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“…In GIST, Ki-67 expression has been previously associated to morphological variables and also survival, but results are hardly comparable due to methodological different approach 19,20,23,31 .…”

Section: Discussionmentioning

confidence: 99%

“…Preliminary results from our group 10 and also from Ando et al 19 suggested that Ki-67 expression is a powerful prognostic tool We used a previously described method for Ki-67 assessment (Allred method for estrogen receptor). By using a high score for intensity 13 , since it is assumed that it would be equivalent in all samples and not variable, adapted this method to and presence of necrosis (p=0.0257) endorsed the potential clinical role of this Ki-67 index.…”

Section: Discussionmentioning

confidence: 99%

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Ki-67 expression score correlates to survival rate in gastrointestinal stromal tumors (GIST)

et al. 2012

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PURPOSE: To evaluate the immunohistochemical expression of p16, Ki-67, p53 and Bcl-2 proteins in gastrointestinal stromal tumors (GIST); to assess the possible association between these variables and clinical and histopathological factors of cancer; and to check for prognostic value of these variables (survival and recurrence). METHODS: A sample of 55 patients treated surgically for GIST in three hospitals was studied. The surgically excised tumors were confirmed as GIST by KIT, vimentin, desmin S100 protein, CD117, 1A4 and CD34 assessment in paraffin blocks. RESULTS: Only 9 (16%) cases of GIST were positive for p53, p16 was positive among 43.6%; 80% of GISTs showed staining for Bcl-2. The proliferative index (expressed as the proportion of positive cells) assessed by immunohistochemical expression of Ki-67 was high in 49% of cases. Elevated Ki-67 scores were associated to high histological grade (p=0.0026) and mitosis index, MI (p=0.0001). High Ki-67 index was associated to death. Expression of p53, p16 and Bcl-2 did not correlate to morphological or clinical variables. CONCLUSIONS: Ki-67 immunohistochemical evaluation should be included in preoperative evaluation of GIST biopsies or surgical specimens as a prognostic tool for clinical staging; and all other proteins studied (Bcl-2, p53 and p16) did not play a role in GIST metabolic or carcinogenic process, remaining without prognostic value.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ki-67 expression score correlates to survival rate in gastrointestinal stromal tumors (GIST)

et al. 2012

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“…EUS-FNA of such lesions has a diagnostic yield of up to 91%. 38 Studying the flow of blood can be done by using Doppler ultrasound.…”

Section: Interventional Eus Proceduresmentioning

confidence: 99%

Endoscopic Ultrasound : A New Hope for Patients

Perveen

Dhir²,

Paramasivam³

et al. 2016

J. Bangladesh Coll. Phys.

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“…In a study by Nobuhiro et al [40], preoperative EUS alone and in combination with histopathology/immunohistochemistry was evaluated. The overall accuracy for the diagnosis of malignant GIST was 78 % by EUS imaging alone and 91 % by histopathologic evaluation (H&E staining) of specimens obtained by EUS-FNA.…”

Section: Gastrointestinal Stromal Tumors (Gist)mentioning

confidence: 99%

Molecules and markers for endosonographers: What do we need to know and measure?

Al‐Haddad

Wallace²

2006

Endoscopy

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IntroductionEndoscopic ultrasound (EUS) has become an indispensable tool for the diagnosis and staging for gastrointestinal and thoracic malignancies. Thanks to the safety and reliability of fine needle aspiration (FNA), this has become the method of choice for tissue acquisition from lymph nodes and tumors in various locations within the thoracic and abdominal cavities.In the recent years, EUS-FNA has offered a better understanding of the pathophysiology of cancer. Similar to the adenoma-carcinoma sequence, other cancers including pancreas, lung, and esophagus may follow a comparable multi-step process of carcinogenesis. A necessary component of these is the ability to go ªbeyond cytologyº to use fine needle aspirates to characterize the genomic and proteomic profiles of cancer and precancerous tissue. Molecular characterization of FNA samples: The basic conceptsAlthough DNA is relatively stable in excised tissue, proteins and particularly RNA are unstable and must be handled in special ways to preserve them for characterization. The first role of the endoscopist is to obtain and preserve tissue suitable for further molecular characterization. In the first part of this review, we will focus on these initial steps. The methods for genomic and proteomic analyses are beyond the scope of this article and interested readers are referred to recent reviews [1,2].RNA destroying-enzymes (RNAase enzymes) are very ubiquitous in the environment. Therefore, it is imperative to prevent rapid degradation of RNA in order to preserve fine needle aspirates for genomic studies. The simplest method to do this is through the use of RNAase inhibitor solutions such as RNA-later (Quagen Inc. Valencia Ca, USA) or RNA Stat 60 (RNA STAT-60 ; TEL-TEST, Friendswood, TX, USA). The needle aspirate can be quickly mixed with these reagents. In our laboratory, we immediately place the FNA sample into an eppendorf tube in a wet ice bath, centrifuge in a small desktop device in the EUS room (1000 RPM at 4 deg. C, 1 minute), remove the supernatant, and resuspend the cell pellet in RNA stat 60. If RNA stabilization is not available on-site, the aspirate can also be snap frozen in liquid nitrogen and stored (preferably at ±70 to ±80C) for later RNA stabilization. Every effort should be made to handle the specimen in an RNAase-free environment including clean gloves and a surface that has been cleaned with an RNAase inhibitor solution.In the remainder part of this review, we will focus on organspecific applications of the biological markers. This will include lesions of the pancreas and gastrointestinal stromal tumors (GIST). The use of biomarkers in staging non-small call lung cancer will be discussed in a separate review. Pancreatic lesionsDiagnosis of early pancreatic cancer remains a challenge mainly due to the lack of a standard screening test. Therefore, improving long-term survival relies primarily on detecting and treating early pancreatic cancer and thus reducing the incidence of pancreatic cancer.EUS is increasingly considered a valuable to...

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The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis

Cited by 317 publications

References 27 publications

Ki-67 expression score correlates to survival rate in gastrointestinal stromal tumors (GIST)

Ki-67 expression score correlates to survival rate in gastrointestinal stromal tumors (GIST)

Endoscopic Ultrasound : A New Hope for Patients

Molecules and markers for endosonographers: What do we need to know and measure?

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