Endoscopy 2019; 51(04): S255
DOI: 10.1055/s-0039-1681940
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Stomach and small intestine ePosters
Georg Thieme Verlag KG Stuttgart · New York

GASTRIC SUBMUCOSAL TUMORS: MOLECULAR MARKERS ASSESSMENT ON EUS-FNA SAMPLES

IF Cherciu
1   University of Medicine and Pharmacy Craiova, Craiova, Romania
,
IM Cazacu
1   University of Medicine and Pharmacy Craiova, Craiova, Romania
,
ET Ivan
1   University of Medicine and Pharmacy Craiova, Craiova, Romania
,
A Saftoiu
2   Gastroenterology, University of Medicine and Pharmacy Craiova, Craiova, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Gastric submucosal lessions might have a benign or malign character. In order to determine the diagnosis of gastric submucosal tumors an important role is played by the endoscopic ultrasound (EUS) assessment. Solely EUS can not help to distinguish specific aspects of the pathology, for instance the degree of malignancy. EUS-guided fine-needle aspiration (EUS-FNA) is more useful in clarifing this distinctions through the use of immunohistochemical staining or genotype analysis. The aim of our study was to conduct a systematic review of literature assessing different molecular markers performed on gastric EUS-FNA samples in order to outline the most widely investigated diagnostic markers which might be further used in the early management of small gastric submucosal tumors. The biomarkers tested on a limited EUS-FNA sample would not only aid the diagnosis but it would allow furthermore a better patients stratification for therapies, hence an immediate clinical impact.

Methods:

A systematic literature search was carried out in three major databases which are as follows: PubMed, Scopus, and Web of Science covering the period 2000 – 2018. The analysis was performed using the population intervention comparison outcome (PICO) format: (P) patients undergoing EUS-FNA for diagnosis of gastric submucosal lessions; different immunohistochemical/genetic biomarkers (I) and cytological analysis (C) were carried out on the samples obtained by EUS-FNA, the outcome (O) being the diagnostic accuracy of the biomarkers.

Results:

20 articles were selected for the systematic review. Overall, the studies have reported the following biomarkers: c-kit (CD177), CD34, MIB-1-Ki67 index, DOG1, desmin, S-100, smooth muscle actin, gene mutation (KIT, PDGFRA). No pathogenic alterations were found in PIK3CA, BRAF, KRAS, NRAS, or FGFR3. GISTs are defined as (CD117)-positive tumors, leiomyomas as desmin-positive and c-kit-negative tumors while schwannomas are S-100-positive and c-kit-negative tumors.

Conclusions:

The biomarkers must be further investigated in various combinations in order to select the optimal panel for clinical use.