Mitotic count of fine needle aspiration material of gastrointestinal stromal tumours of the stomach underestimates actual mitotic count.
biopsy
fine needle
gastrointestinal stromal tumors
mitosis
mitotic count
stomach
Journal
Cytopathology : official journal of the British Society for Clinical Cytology
ISSN: 1365-2303
Titre abrégé: Cytopathology
Pays: England
ID NLM: 9010345
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
26
07
2021
received:
24
03
2021
accepted:
12
08
2021
pubmed:
15
8
2021
medline:
5
4
2022
entrez:
14
8
2021
Statut:
ppublish
Résumé
A mitotic count is required for histological grading in resections of gastrointestinal stromal tumours (GISTs). However, no consensus on the utility of mitotic count in fine needle aspiration (FNA) GIST material currently exists. This study examines the relationship between mitotic counts of FNAs and subsequent resections of GISTs of the stomach. We identified 39 cases of GISTs of the stomach diagnosed via FNA at our institution between January 1, 2014, and December 31, 2019, with subsequent resection. We noted if rapid on-site evaluation (ROSE) was performed. Cell block (CB) material from FNAs was analysed for total area, percentage containing neoplastic cells, and number of mitoses. We compared the mitotic counts in CBs and subsequent resections with t tests. ROSE was performed in 82% of cases and called adequate every time. Mean values for total CB area, neoplastic material percentage, and area of neoplastic cells were 54.7 mm At our institution, ROSE adequacy of spindle cell lesions focuses on diagnosing GIST rather than obtaining adequate material for histological grading. Mitotic figures were statistically lower in FNA CB material than subsequent resections, and using mitotic counts from CB material may underestimate the histological grade of GISTs of the stomach.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
100-106Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Nilsson B, Bümming P, Meis-Kindblom JM, et al. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era-a population-based study in western Sweden. Cancer. 2005;103(4):821-829. 10.1002/cncr.208622
Miettinen M, Lasota J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med. 2006;130(10):1466-1478. 10.5858/2006-130-1466-GSTROM
Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23(2):70-83. 10.1053/j.semdp.2006.09.001
Nagtegaal ID, Odze RD, Klimstra D, et al. The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020;76(2):182-188. 10.1111/his.13975
Akahoshi K, Oya M, Koga T, Shiratsuchi Y. Current clinical management of gastrointestinal stromal tumor. World J Gastroenterol. 2018;24(26):2806-2817. 10.3748/wjg.v24.i26.2806
Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 2008;39(10):1411-1419. 10.1016/j.humpath.2008.06.025
Sepe PS, Moparty B, Pitman MB, Saltzman JR, Brugge WR. EUS-guided FNA for the diagnosis of GI stromal cell tumors: sensitivity and cytologic yield. Gastrointest Endosc. 2009;70(2):254-261. 10.1016/j.gie.2008.11.038
Fletcher CDM, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol. 2002;33(5):459-465. 10.1053/hupa.2002.123545
Akahoshi K, Oya M, Koga T, et al. Clinical usefulness of endoscopic ultrasound-guided fine needle aspiration for gastric subepithelial lesions smaller than 2 cm. J Gastrointestin Liver Dis. 2014;23(4):405-412. 10.15403/jgld.2014.1121.234.eug
Larghi A, Fuccio L, Chiarello G, et al. Fine-needle tissue acquisition from subepithelial lesions using a forward-viewing linear echoendoscope. Endoscopy. 2014;46(1):39-45. 10.1055/s-0033-1344895
Mekky MA, Yamao K, Sawaki A, et al. Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors. Gastrointest Endosc. 2010;71(6):913-919. 10.1016/j.gie.2009.11.044
Akahoshi K, Sumida Y, Matsui N, et al. Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration. World J Gastroenterol. 2007;13(14):2077-2082. 10.3748/wjg.v13.i14.2077
Schmidt RL, Witt BL, Lopez-Calderon LE, Layfield LJ. The influence of rapid onsite evaluation on the adequacy rate of fine-needle aspiration cytology: a systematic review and meta-analysis. Am J Clin Pathol. 2013;139(3):300-308. 10.1309/AJCPEGZMJKC42VUP
Shield PW, Cosier J, Ellerby G, Gartrell M, Papadimos D. Rapid on-site evaluation of fine needle aspiration specimens by cytology scientists: a review of 3032 specimens. Cytopathology. 2014;25:322-329.
Chatzipantelis P, Konstantinou P, Kaklamanos M, Apostolou G, Salla C. The role of cytomorphology and proliferative activity in predicting biologic behavior of pancreatic neuroendocrine tumors: a study by endoscopic ultrasound-guided fine-needle aspiration cytology. Cancer. 2009;117(3):211-216. 10.1002/cncy.20025
Farrell JM, Pang JC, Kim GE, Tabatabai ZL. Pancreatic neuroendocrine tumors: accurate grading with Ki-67 index on fine-needle aspiration specimens using the WHO 2010/ENETS criteria. Cancer Cytopathol. 2014;122(10):770-778. 10.1002/cncy.21457
Weiss VL, Kiernan C, Wright J, Merchant NB, Coogan AC, Shi C. Fine-needle aspiration-based grading of pancreatic neuroendocrine neoplasms using Ki-67: is accurate WHO grading possible on cytologic material? J Am Soc Cytopathol. 2018;7(3):154-159. 10.1016/j.jasc.2018.02.001
Ando N, Goto H, Niwa Y, et al. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. Gastrointest Endosc. 2002;55(1):37-43. 10.1067/mge.2002.120323
Ricci R, Chiarello G, Attili F, et al. Endoscopic ultrasound-guided fine needle tissue acquisition biopsy samples do not allow a reliable proliferation assessment of gastrointestinal stromal tumours. Dig Liver Dis. 2015;47(4):291-295. 10.1016/j.dld.2014.12.011
Pyo JS, Kang G, Sohn JH. Ki-67 labeling index can be used as a prognostic marker in gastrointestinal stromal tumor: a systematic review and meta-analysis. Int J Biol Markers. 2016;31(2):e204-e210. 10.5301/jbm.5000183
Paiella S, Landoni L, Rota R, et al. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis and grading of pancreatic neuroendocrine tumors: a retrospective analysis of 110 cases. Endoscopy. 2020;52(11):988-994. 10.1055/a-1180-8614
Hasegawa T, Yamao K, Hijioka S, et al. Evaluation of Ki-67 index in EUS-FNA specimens for the assessment of malignancy risk in pancreatic neuroendocrine tumors. Endoscopy. 2014;46(1):32-38. 10.1055/s-0033-1344958
Puri M, Hoover SB, Hewitt SM, et al. Automated computational detection, quantitation, and mapping of mitosis in whole-slide images for clinically actionable surgical pathology decision support. J Pathol Inform. 2019;10:4. 10.4103/jpi.jpi_59_18
Balkenhol MCA, Tellez D, Vreuls W, et al. Deep learning assisted mitotic counting for breast cancer. Lab Invest. 2019;99(11):1596-1606. 10.1038/s41374-019-0275-0
Pantanowitz L, Hartman D, Qi Y, et al. Accuracy and efficiency of an artificial intelligence tool when counting breast mitoses. Diagn Pathol. 2020;15(1):80. 10.1186/s13000-020-00995
Abi-Raad R, Lavik J-P, Barbieri AL, Zhang X, Adeniran AJ, Cai G. Grading pancreatic neuroendocrine tumors by Ki-67 index evaluated on fine-needle aspiration cell block material. Am J Clin Pathol. 2020;153(1):74-81. 10.1093/ajcp/aqz110
Satturwar SP, Pantanowitz JL, Manko CD, Seigh L, Monaco SE, Pantanowitz L. Ki-67 proliferation index in neuroendocrine tumors: can augmented reality microscopy with image analysis improve scoring? Cancer Cytopathol. 2020;128(8):535-544. 10.1002/cncy.22272