Project/Area Number |
11670894
|
Research Category |
Grant-in-Aid for Scientific Research (C)
|
Allocation Type | Single-year Grants |
Section | 一般 |
Research Field |
Radiation science
|
Research Institution | KYUSHU UNIVERSITY |
Principal Investigator |
INO Akihiro (2001) Graduate School of Medical Sciences, Kyushu University Research Assistant, 大学院・医学研究院, 助手 (50294947)
川元 健二 (1999-2000) 九州大学, 医学部・附属病院, 講師 (00253427)
|
Co-Investigator(Kenkyū-buntansha) |
UEDA Masanobu Faculty of Medicine, Kyushu University Resident, 医学部・附属病院, 医員
HIRAKA Kiyohisa Faculty of Medicine, Kyushu University Research Assistant, 医学部・附属病院, 助手 (50335973)
井野 彰浩 九州大学, 医学部・附属病院, 助手 (50294947)
宇都宮 尚 国立九州医療センター, 医師
|
Project Period (FY) |
1999 – 2001
|
Project Status |
Completed (Fiscal Year 2001)
|
Budget Amount *help |
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2001: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2000: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 1999: ¥1,300,000 (Direct Cost: ¥1,300,000)
|
Keywords | submucosal tumor / ultrasonography-guided / fine needle aspiration cytology / fine needle aspiration histology / tumor diagnosis / malignancy evaluation |
Research Abstract |
Endoscopic ultrasonography-guided fine needle aspiration was performed in 42 cases, 25 of which were submucosal tumors and 17 of which were extragastrointestinal tumor between 1999 and 2001. In the diagnosis of submucosal tumors the annual percentages of successful sampling for fine needle aspiration cytology (FNAC) were 57.1% (8/14), 83.3% (5/6) and 100% (5/5) in chronological order, and specimens for fine needle aspiration biopsy (FNAB) were obtained with reliability of 0% (0/14), 50% (3/6) and 100% (5/5) each year. Thus, the preparation of histologic specimens has technically become feasible with considerable reliability due to improvements in needles and other devices as well as in puncture techniques. Regarding extragastrointestinal tumors, both samples for FNAC and FNAB were obtained with comparatively favorable outcomes from the earliest stages of the study. Specimens were obtained from 8 cases with submucosal tumors, including 7 with a suspected diagnosis of gastrointestinal st
… More
romal tumors (GIST) and one with ectopic pancreas. We conducted immunostaining in 7 suspected cases of GIST and consequently characterized them as follows: smooth muscle type (4), neural type (3), combined type (0), and uncommitted type (1). In 6 (85.7%) of 7 cases, the preoperative diagnosis was consistent with subcategories derived from the final diagnosis on surgical specimens. Because of minor differences in staining, only one case that was initially classified into the uncommitted type was diagnosed as a smooth muscle type in the postoperative investigation. This suggests that it is possible to subcategorize submucosal tumors by using our preoperative diagnostic procedures. Based on clinical courses and surgical outcomes, a total of 25 submucosal tumor cases were differentiated into 4 malignant (including low-grade malignancy) and 21 benign cases. The differential accuracy, which was 60% when diagnosed simply by observing mitotic figures in FNAB samples, was improved to 80% when cellular atypism in FNAB and FNAG samples was concomitantly evaluated in the diagnosis. These diagnostic procedure demonstrated high accuracy. However, considering other factors in this study such as a high percentage of benign cases in the target population and a low (50%) sensitivity for analyses, we conclude that mitotic figures as well as cellular atypism will not complete a preoperative differential diagnosis between benign and malignant tumors. We have established reliable sampling procedure throughout the study and currently demonstrate that the specimens can be labeled with ki67, which is considered to indicate the proliferative capacity of submucosal tumors. Further studies will be conducted in order to investigate correlations between ki67 labeling index in a preoperative specimen and that measured in a surgical specimen, and to evaluate if the proliferative capacity can be a predictive indicator of benign or malignant submucosal tumor during the preoperative period. Less
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