2023 Volume 7 Pages 34-41
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.
