Ge QC, Wu YF, Liu ZM, Wang Z, Wang S, Liu X, Ge N, Guo JT, Sun SY. Efficacy of endoscopic ultrasound in the evaluation of small gastrointestinal stromal tumors. World J Gastroenterol 2022; 28(37): 5457-5468 [PMID: 36312832 DOI: 10.3748/wjg.v28.i37.5457]
Corresponding Author of This Article
Jin-Tao Guo, MD, PhD, Professor, Department of Gastroenterology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. guojt@sj-hospital.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 7, 2022; 28(37): 5457-5468 Published online Oct 7, 2022. doi: 10.3748/wjg.v28.i37.5457
Efficacy of endoscopic ultrasound in the evaluation of small gastrointestinal stromal tumors
Qi-Chao Ge, Yu-Fan Wu, Zi-Ming Liu, Zhe Wang, Sheng Wang, Xiang Liu, Nan Ge, Jin-Tao Guo, Si-Yu Sun
Qi-Chao Ge, Yu-Fan Wu, Zi-Ming Liu, Sheng Wang, Xiang Liu, Nan Ge, Jin-Tao Guo, Si-Yu Sun, Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Zhe Wang, Department of Pathology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Ge QC wrote a majority portion of manuscript, prepared the figures and tables, and performed statistical analysis; Wu YF collected the data of patients; Liu ZM helped with the statistical analysis and manuscript writing; Wang Z provided and confirmed the pathological data of all the patients; Wang S, Liu X, and Ge N took part in the design of the study outline and performed tumor dissection; Guo JT and Sun SY were responsible for the revision of the manuscript for important intellectual content and supervised the study; all the authors read and gave their final approval for the manuscript to be submitted.
Supported byNational Natural Science Foundation of China, No. 81900601; The University Innovation Team and Innovative Talent Support Program of Liaoning Province, No. LR2019073; and Shenyang Young and Middle-aged Science and Technology Innovation Talent Support Program, No. RC200438.
Institutional review board statement: This study was approved by the Ethics Review Committee of Shengjing Hospital of China Medical University, No. 2022PS009K.
Informed consent statement: All the individual involved gave their informed consent prior to study inclusion.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Tao Guo, MD, PhD, Professor, Department of Gastroenterology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. guojt@sj-hospital.org
Received: June 22, 2022 Peer-review started: June 22, 2022 First decision: September 2, 2022 Revised: September 14, 2022 Accepted: September 20, 2022 Article in press: September 20, 2022 Published online: October 7, 2022 Processing time: 98 Days and 23.1 Hours
ARTICLE HIGHLIGHTS
Research background
Small gastrointestinal stromal tumors (GISTs) have a high incidence, and their prognosis and treatment remain controversial.
Research motivation
Endoscopic ultrasound (EUS) plays a pivotal role in the diagnosis of GISTs, but its ability to assess the prognosis of small GISTs remains to be explored.
Research objectives
To evaluate the efficacy of EUS in the diagnosis and risk assessment of small GISTs.
Research methods
We collected data from patients with small GISTs, the diagnosis and risk classifications of which were based on the pathological assessment according to the modified National Institute of Health criteria after endoscopic resection or laparoscopic surgery. The assessment results based on EUS features (marginal irregularity, cystic changes, homogeneity, ulceration, and strong echogenic foci) were compared with the pathological features.
Research results
A total of 256 patients (69 men and 187 women) were enrolled. Tumor size was positively correlated with the mitotic index (P < 0.001). Receiver operating curve analysis identified 1.48 cm as the best cut-off value to predict malignant potential (95% confidence interval: 0.824–0.956). EUS heterogeneity with tumor diameters > 1.48 cm was associated with higher risk classification (P < 0.05).
Research conclusions
Small GISTs (diameters, > 1.48 cm) with positive EUS features should receive intensive surveillance or undergo endoscopic surgery. EUS and dissection are efficient diagnostic and therapeutic approaches for small GISTs.
Research perspectives
EUS provides reference evidence for the precise assessment and early risk assessment of small GISTs.
