Tokyo Women's Medical University Journal (Mar 2023)

New Risk Classification of Gastrointestinal Stromal Tumors Based on Tumor Size and Three Indices Derived from Rapid Flow Cytometry of Fine-Needle Aspiration Specimens

  • Kiyoaki Taniguchi,
  • Akane Suzuki,
  • Akiko Serizawa,
  • Sho Kotake,
  • Shunichi Ito,
  • Kazuomi Suzuki,
  • Sho Izumika,
  • Masaho Ota,
  • Yoshihiro Muragaki,
  • Masakazu Yamamoto

DOI
https://doi.org/10.24488/twmuj.2022014
Journal volume & issue
Vol. 7, no. 0
pp. 34 – 41

Abstract

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Background: Biopsies of suspected gastrointestinal stromal tumors in submucosal locations, which were once a challenge, are now easily performed with endoscopic ultrasound-guided fine-needle aspiration. However, fine-needle aspiration biopsy (FNAB) specimens may be inadequate for the diagnosis of malignancy using quantification of histological mitotic count. Methods: We devised a procedure for rapid analysis with an algorithm for clinical use. DNA ploidy analysis conducted using flow cytometry determined the mitotic rate, which correlated with clinical prognostic factors (mitotic count and the Ki-67 labeling index). We then developed a risk classification system for gastrointestinal stromal tumors using flow cytometry parameters and tumor size. Results: The combined flow cytometry and tumor size parameters correlated with the modified-Fletcher risk classification of gastrointestinal stromal tumors. Conclusion: Rapid flow cytometry of endoscopic ultrasound-guided FNAB specimens can be used to diagnose gastrointestinal stromal tumors and assign a modified-Fletcher risk classification.

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