Characteristics and endoscopic ultrasound findings of gastrointestinal lesions: single-center experience

Abstract

Aims: We aimed to present the characteristics, indications, endoscopic ultrasonography procedure details, diagnoses and complication rate of patients who underwent endosonpgraphy in a single center. Methods: Forty six patients admitted to Trakya Unversity Faculty of Medicine and underwent EUS (±FNA) procedure between January 2021 and May 2022 were included in the study. Patients files were analysed retrospectively. Demographic characteristics, presence and types of comorbidity, presence and types of malignancy in the family, use of antithrombotic drugs, laboratory data, details of eus procedure, pathology results, adverse events were recorded. The data obtained in the study were analyzed using Statistical Package for Social Science for Windows 26 package program. Results: A total of 46 patients were included in the study. 46% (n=21) were women. The median age was 64 (28-87). Antithrombotic use was present in 25% of the patients. Comorbidities were present in 84% of patients. The indications for EUS were predominantly pancreatic lesions (n=31). Aspirations were performed in addition to ultrasonographic examination in 78% (n=36) of the patients. 19 G (Gauge) needles were used in 30 and 25 G needles were used in 6 patients. Biopsy stations were stomach (n=31), duodenum (n=4), esophagus (n=1). Median long axis of the lesions was 34 (7-173) mm and the short axis was 26 (1-76) mm. 42% of the biopsied pancreatic lesions were cystic and 58% were solid. The CA19-9 level in solid lesions was statistically significantly higher than cystic (1512 /28 U/ml; p= 0.008). CA19-9 level was found mean 2061±3295 U/ml in patients with adenocarcinoma (n=8), 71±106 U/ml in cystic neoplasm and 152±338 in benign disorders (p=0.026). Cut-off value predicting adenocarsinoma with %87,5 spesifity and %87,5 sensitivity in our cohort was 174 U/ml (( AUC 0.85 ( 0.63-1)). Spesifity and sensitivity of the level 40 ( nearest level to universaly detected upper limit: 37 U/mL) was %62,5 and %87,5 respectively. Comparing malignant and benign lesions of pancreas overall, no statistical significance was found of CA19-9 level in predicting the diagnosis of tumor (p=0.15). Of the patients who underwent biopsy, 61% were malignant and 39% were benign. Malignant diagnoses were: adenocarsinoma, cystic neoplasm, gastrointestinal stromal tumor, neuroendocrine tumor, mesenchymal tumor, lumphoma, metastasis. Benign diagnoses were: otoimmune pancreatitis, normal cyst, chronic pancreatitis, pseudocyst, walled-off necrosis, polyp, no lesion. Post-procedure complications were not observed in any of the patients. Conclusion: The availability of endoscopic ultrasonography is expanding nowadays. Endoscopy ultrasonography is a precise, advantageous, and risk-free technique when performed by trained personnel.