title: [Endoscopic ultrasonography-guided management of mesenchymal tumors of the upper digestive tract].
abstract: Stromal tumours of the gastrointestinal tract can be defined by endoscopic ultrasonography as "hypoechoic intramural tumours" on the basis of their echostructure. Unfortunately, this definition is inadequate for distinguishing between the biological behaviour patterns of different types of stromal tumour. One hundred and twelve hypoechoic intramural tumours observed from 1998 to 2005 were classified in 4 distinct groups (leiomyomas, gastrointestinal stromal tumours, gastrointestinal stromal tumours suspected of malignancy, and malignant stromal tumours) according to more detailed endoscopic ultrasonography criteria in order to better plan the surgical treatment. The endoscopic ultrasonography diagnosis was compared with histology and immunochemistry findings in 33 patients who were operated on. The overall accuracy was 78.6% for the diagnosis of leiomyoma (sensitivity, specificity, positive predictive value, and negative predictive value were 92.3%, 90.0%, 85.7% and 94.7%, respectively). The corresponding data for the diagnosis of malignant stromal tumours were 80.0%, 95.2%, 88.9% and 91.7%. Endoscopic ultrasonography seemed to be less reliable only in relation to the diagnosis of gastrointestinal stromal tumours (specificity 80.9%, positive predictive value 75.0%). The surgical procedures planned on the basis of the endoscopic ultrasonography diagnosis proved adequate in 31 out of 33 cases.
authors.affiliation: Dipartimento di Scienze Medico-Chirurgiche Facoltà di Medicina e Chirurgia Seconda Università degli Studi di Napoli.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Napolitano
authors.forename: Gianluca
authors.initials: G
authors.lastname: Russo
authors.forename: Angelo
authors.initials: A
authors.lastname: Pezzullo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Maffettone
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rossetti
authors.forename: Gianmattia
authors.initials: G
authors.lastname: del Genio
authors.forename: Luigi
authors.initials: L
authors.lastname: Brusciano
authors.forename: Francesco
authors.initials: F
authors.lastname: Pizza
authors.forename: Carlo
authors.initials: C
authors.lastname: Sagnelli
authors.forename: Alberto
authors.initials: A
authors.lastname: del Genio
mesh_terms: D019160:Endosonography; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods