FACTORS AFFECTING THE DIAGNOSTIC YIELD OF ENDOSCOPIC ULTRASOUND GUIDED BIOPSY OF SUB EPITHELIAL LESIONS IN GASTROINTESTINAL TRACT

Abstract

Background: Subepithelial lesions (SELs) of the gastrointestinal (GI) tract are often incidental findings during endoscopy, and their evaluation can be challenging. Endoscopic ultrasound-guided biopsy (EUS-GEB) has emerged as a key diagnostic tool for obtaining tissue samples from SELs, yet its diagnostic yield varies due to multiple procedural and lesion-related factors. Objective: To evaluate the factors influencing the diagnostic yield of endoscopic ultrasound-guided biopsy (EUS-GEB) in the assessment of gastrointestinal subepithelial lesions. Study Design: Descriptive study. Setting: Hayatabad Medical Complex, Peshawar, Pakistan. Duration of Study: July 2024 to January 2025. Methods: A total of 60 patients who underwent EUS-GEB for SELs in the gastrointestinal tract were included. Clinical and procedural data were collected, including lesion size, location, echogenicity, needle size, number of needle passes, and endoscopist experience. Histopathological evaluation was conducted on all biopsy samples. Diagnostic yield was defined as the percentage of procedures resulting in a definitive histological diagnosis. Statistical analyses were performed using appropriate tests to identify significant predictors of diagnostic yield. Results: Among the 60 patients enrolled, most lesions were located in the stomach (63.3%) and esophagus (18.3%). The overall diagnostic yield was 68.3%. Lesions larger than 20 mm, more than three needle passes, and procedures performed by more experienced endoscopists were significantly associated with higher diagnostic yield (p < 0.05). Conclusion: Lesion size, the number of needle passes, and endoscopist experience are key factors that significantly affect the diagnostic yield of EUS-GEB in evaluating subepithelial lesions of the GI tract. Optimizing these variables may improve diagnostic accuracy and clinical outcomes.