TY - JOUR AU - O. G. Kuryk AU - M. Yu. Kolomoyets AU - V. O. Yakovenko AU - R. P. Tkachenko PY - 2018/10/25 Y2 - 2024/03/29 TI - Pathomorphological characteristics of non-epithelial submucosal gastric tumors removed by endoscopic submucosal dissection JF - Clinical and Preventive Medicine JA - Clin. and prev. med. VL - IS - 2-3 SE - Clinical medicine DO - 10.31612/2616-4868.2-5.2018.12 UR - http://cp-medical.com/index.php/journal/article/view/27 AB - Non-epithelial submucosal gastric lesions (NSGL) are frequently identified during routine upper endoscopies.  Endoscopic ultrasonography is one of the most useful modalities for diagnosing NSGL. Endoscopic submucosal dissection (ESD) is an advanced endoscopic therapy for NSGL and ESD has rapidly become widely used. Histological diagnosis of the removed tumor is important for the further tactics and prognosis.Methods. We studied clinical and morphological data of the 21 patients with NSGL who underwent ESD in our hospital “Oberig clinic” between 2009 and  2017 years.  All patients underwent EUS before the procedure (Olympus EUS EXERA EU-M60, UM DP20-25R). ESD were performed by one experienced endoscopist. (Olympus Exera II, GIF Q-160Z;  Olympus Exera III, GIF HQ-190).Immunohistochemical staining for c-kit (CD117), DOG-1, CD34, desmin, smooth muscle antigen (SMA), or S-100 protein was performed to differentiate tumors of mesenchymal origin. Mesenchymal lesions that stained positive for SMA and desmin were diagnosed as leiomyomas. Lesions that stained positive for c-kit or DOG-1 and CD34 were diagnosed as GISTs. Lesions that stained positive for S-100, chromogranin A,  neuron-specific enolase  were diagnosed as neuroendocrine tumors. The malignant potential was categorized based on tumor size, mitotic counts and malignant potential was determined with Ki-67.Results. The patients included 9 men and 14 women with a median age of 57 years (range: 25–67 years). On EUS, 18 tumors (81%)(79%; 95% confidence interval 62,4-95,6%)  were located in the submucosal  layer and 5 (21%; 95% confidence interval 4,4-37,6%) – in the muscularis propria  layer. Median tumor size was 10 mm (range: 4–35 mm). The tumor sizes were ≤ 20 mm in 19 lesions (86%; 95% confidence interval 71,8-100%) and > 20 mm in 4 (14%; 95% confidence interval 0-28,2%). The histological diagnoses were neuroendocrine tumor (n = 9), GIST (n = 5), leiomyoma (n = 4),  inflammatory fibrinoid polyp (n = 2),  glomus tumor (n = 1), calcifying fibrous tumour (n = 1), aberrant pancreas (n = 1).Conclusion.  The  ESD is an effective and safe treatment for gastric SMTs, which can resect the whole lesion. The final histopathological diagnosis for most NSGL is only possible after the immunohistochemical study. ER -