期刊
JOURNAL OF CLINICAL ULTRASOUND
卷 43, 期 2, 页码 89-97出版社
WILEY
DOI: 10.1002/jcu.22195
关键词
GIST; angiogenesis; contrast-enhanced endoscopic ultrasonography; risk classification
BackgroundThe aim of this study was to elucidate the histologic and clinical implications of detection of intratumoral vessels on contrast-enhanced endoscopic ultrasonography (CE-EUS) in gastrointestinal stromal tumors (GISTs). MethodsThirteen patients with a GIST, all of whom were referred for surgery, underwent presurgical CE-EUS. The malignant potential, assessed according to the modified Fletcher risk classification system, and the histologic degree of angiogenesis were compared with the presence or absence of intratumoral vessels on CE-EUS. ResultsOf the six tumors with intratumoral vessels observed on CE-EUS, five were intermediate- or high-risk GISTs, and the remaining seven negative cases were categorized as very low risk or low risk. The presence of intratumoral vessels on CE-EUS was significantly correlated with a higher-risk classification (p=0.005). On histologic examination, all GISTs having visualized vessels incorporated vessels of more than 500 m in diameter. The large intratumoral vessels of the five intermediate- or high-risk GISTs lacked elastic fibers, suggesting that they were neovascular in nature. These higher-risk tumors were also found, by immunohistochemical analysis, to have high expression of vascular endothelial growth factor. ConclusionsIntratumoral vessels observed in GISTs on CE-EUS are correlated with a higher degree of angiogenesis, resulting in higher malignant potential. (c) 2014 Wiley Periodicals, Inc. J Clin Ultrasound, 43:89-97, 2015
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