Effect of wet-heparinized suction on the quality of mediastinal solid tumor specimens obtained by endoscopic ultrasound-guided fine-needle aspiration: a retrospective study from a single center.

BACKGROUND: Mediastinal lesions are diagnosed sometimes by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Wet-heparinized suction technique has been used to improve the quality of abdominal solid tumor samples obtained by EUS-FNA. The aim of the study is to assess the effect of wet-heparinized suction on the quality of mediastinal solid tumor samples and to evaluate the safety of the method. METHODS: The medical records, EUS-FNA records, pathologic data, and follow-up data between the patients who suspected mediastinal lesions with wet-heparinized suction and conventional suction were retrospectively and comparatively analyzed. Adverse events at 48 h and 1 week after EUS-FNA were evaluated. RESULTS: Wet-heparinized suction contributed to more tissue specimens (P < 0.05), superior tissue integrity (P < 0.05), and a longer length of white tissue core (P < 0.05). In addition, the more complete the tissue bar was, the higher the rate of successful sample (P < 0.05). Moreover, the total length of the white tissue bar at the first puncture was remarkably longer in the Experimental group (P < 0.05). No significant difference in red blood cell contamination in paraffin sections was found between the two groups (P > 0.05). There was no complication after discharge in both groups. CONCLUSION: Wet-heparinized suction can improve the quality of mediastinal lesion samples obtained by EUS-FNA and increase the success rate of sampling. In addition, it will not aggravate blood contamination in paraffin sections while ensuring a safe puncture.

The value of color Doppler ultrasonography combined with serum tumor markers in differential diagnosis of gastric stromal tumor and gastric cancer.

This study aimed to explore the value of color Doppler ultrasonography combined with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in differential diagnosis of gastric stromal tumor (GST) and gastric cancer (GC). An analysis of the clinical data of 180 patients with clinically suspected gastric space occupying lesions. According to the postoperative pathological results, 180 suspected gastric space-occupying lesion patients were divided into GST group (n = 83) and GC group (n = 97). Color Doppler ultrasonography, serum tumor markers CEA and CA19-9 were compared. The research results showed that serum CEA and CA19-9 levels were lower in patients with GST group than those with GC group (both P < 0.001). With postoperative pathology as the gold standard, detection rates of GST and GC by combination of color Doppler ultrasound (CDUS), serum CEA, and CA19-9 were higher than those of each index alone (both P < 0.001). There was no difference between detection rates of GST and GC by combination of CDUS, serum CEA, and CA19-9 (P = 0.058). Color Doppler ultrasonography combined with serum tumor markers CEA and CA19-9 tests has a certain differential diagnostic value for GST and GC, which may provide a reliable reference basis for clinical diagnosis and treatment.

Detection value of endoscopic ultrasound-guided 19G fine-needle wet-heparinized suction for pancreatic solid tumors: a randomized controlled trial.

Background: Conventional endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has some inevitable flaws in the detection of pancreatic solid tumors, such as an incomplete histological structure of the obtained pancreatic biopsy tissues and blood coagulation. Heparin can prevent blood coagulation, thus improving the structural integrity of the specimen. However, whether the combination of EUS-FNA and wet heparin can improve the detection of pancreatic solid tumors needs to be further explored. Hence, this study aimed to compare the EUS-FNA combined with wet heparin and the conventional EUS-FNA, and analyze the detection value of EUS-FNA combined with wet heparin for pancreatic solid tumors. Methods: The clinical data of 52 patients with pancreatic solid tumors who had received EUS-FNA at the Wuhan Fourth Hospital from August 2019 to April 2021 were selected. Patients were divided into a heparin group and a conventional wet-suction group using a randomized number table. The total length of biopsy tissue strips, total length of white tissue core in pancreatic biopsy lesions [according to macroscopic on-site evaluation (MOSE)], total length of white tissue core in each biopsy tissue, erythrocyte contamination in the paraffin sections, and postoperative complications were compared between the groups. The receiver operating characteristic curve was used to reflect the detection value of EUS-FNA combined with wet heparin for pancreatic solid tumors. Results: The heparin group had a longer total length of biopsy tissue strips (P<0.05) and total length of white tissue core (P<0.05) than the conventional group. There was a positive correlation between the total length of white tissue core and the total length of biopsy tissue strips in both groups (conventional wet-suction group: r=0.470, P<0.05; heparin group: r=0.433, P<0.05). The heparin group had milder erythrocyte contamination in the paraffin sections (P<0.05). The total length of white tissue core in the heparin group had the highest diagnostic performance, with a Youden index of 0.819 [area under the curve (AUC) =0.944]. Conclusions: Our research shows that wet-heparinized suction improves the quality of pancreatic solid tumor tissue biopsy obtained by 19G fine-needle aspiration and is a safe and efficient aspiration method in conjunction with MOSE for tissue biopsy. Trial Registration: Chinese Clinical Trial Registry ChiCTR2300069324.

Diagnosis of gastric duplication cyst by positron emission tomography/computed tomography: A case report.

BACKGROUND: Gastric duplication cysts (GDCs) are extremely uncommon lesions and the definitive diagnosis of GDCs is challenging for gastrointestinal specialists. It is important that a differential diagnosis is performed to rule out the possibility of other diseases, mainly malignancies with a cystic component. Despite the use of multiple diagnostic modalities including endoscopy, the preoperative diagnosis of GDCs is challenging. CASE SUMMARY: A 53-year-old female patient with a GDC was confirmed by positron emission tomography/computed tomography (PET/CT) instead of more conventional procedures such as endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). We propose that 18F-FDG-PET/CT has higher accuracy than EUS-FNA and may be an effective technique for the characterization of duplication cysts. CONCLUSION: Preoperative diagnosis of GDCs in adults is difficult largely due to their rarity and the absence of characteristic findings. In addition, few endoscopists include GDCs in the differential diagnosis when they encounter a lesion with cystic characteristics. 18F-FDG-PET/CT with additional imaging data, may complement EUS-FNA in the diagnosis of GDCs.

IgG4 positive autoimmune pancreatitis: report of a case and review of literature.

Autoimmune pancreatitis (AIP) is a rare chronic pancreatitis and the incidence is increasing recently. However, the formal report of this disease is still rare in literatures. Here, we reported a rare case of IgG4 positive autoimmune pancreatitis to make the awareness of this type of disease. The patient was a 58-year-old Chinese male who was suffered from epigastric pain accompanied by nausea and vomiting. An occupying lesion was detected in the body of the pancreas tail with the ultrasound examination. The serum IgG4 levels, white blood cells, blood amylase and the γ-globulin fraction were all increased. After operation, the following pathological detection with immunochemistry test confirmed the diagnosis of autoimmune pancreatitis.

Diagnostic significance of CK19, galectin-3, CD56, TPO and Ki67 expression and BRAF mutation in papillary thyroid carcinoma.

The aim of the present study was to examine the rate of BRAF mutation and the expression profiles of CK19, galectin-3, CD56, thyroid peroxidase (TPO) and Ki67 in papillary thyroid carcinoma (PTC) and papillary thyroid micro-carcinoma (PTMC). A total of 246 cases of thyroid disease were collected, including PTC, PTMC, nodular goiter (NG) and Hashimoto thyroiditis (HT). The results revealed that CK19 expression was 116/120 in PTC, 61/64 in PTMC, 2/34 in NG and 1/28 in HT. Galectin-3 positive expression was 115/120 in PTC, 60/64 in PTMC, 6/34 in NG and 4/28 in HT. TPO positive expression was 8/120 in PTC, 1/64 in PTMC, 30/34 in NG and 25/28 in HT. CD56-positive expression was 12/120 in PTC, 3/64 in PTMC, 33/34 in NG and 26/28 in HT. Ki67 labeling index was 2.52±0.46% in PTC (120 cases), 2.62±0.52% in PTMC (64 cases), 2.55±0.44% in NG (34 cases) and 2.58±0.48% in HT (28 cases). BRAF mutation rate was 93/120 in PTC, 47/64 in PTMC, 3/34 in NG and 2/28 in HT. These results suggested that expression patterns of CK19, galectin-3, CD56 and TPO and BRAF mutation exhibit diagnosis value in thyroid disease. However, Ki67-positive rate exhibits no notable diagnosis value in thyroid disease.

Overexpression of the mitochondrial chaperone tumor necrosis factor receptor-associated protein 1 is associated with the poor prognosis of patients with colorectal cancer.

Tumor necrosis factor receptor-associated protein-1 (TRAP-1), a mitochondrial chaperone, contributes significantly to the progression of cancer. However, the understanding of its involvement in the clinicopathological characteristics and prognosis of colorectal cancer (CRC) remains limited. The aim of the present study was to assess the significance of TRAP-1 expression in CRC. The expression of TRAP-1 was evaluated in corresponding cancerous, paracancerous, lymph node and distant metastatic tissues of 256 cases of CRC by immunohistochemistry. The associations between TRAP-1 expression and the clinicopathological parameters and survival rates of patients was assessed. Out of 256 patients with CRC, TRAP-1 expression was detected in 203 (79.3%). TRAP-1 expression was significantly increased in cancerous tissue compared with that in corresponding paracancerous tissues (P<0.001). Overexpression of TRAP-1 was significantly associated with differentiation (P=0.011), depth of invasion (P=0.006), lymph node metastasis (P<0.001) and tumor-node-metastasis stage (P<0.001). In patients with high TRAP-1 expression, the 5-year overall survival (OS) rate was 38.0%, in contrast to 56.5% in patients with low TRAP-1 expression (P=0.003). Similarly, the 5-year progression-free survival (PFS) was 26.6% for patients with high TRAP-1 expression and 53.3% for patients with low TRAP-1 expression (P<0.001). Multivariate analyses indicated the TRAP-1 expression is an independent prognostic factor for poorer OS [P=0.015; hazard ratio (HR), 1.914] and PFS (P<0.001; HR, 2.534). Thus, TRAP-1 may serve as a potential biomarker for predicting the prognosis of patients with CRC. Specifically, overexpression of TRAP-1 may predict progression and poor survival in cases of CRC.