Clinical presentations of gastric small gastrointestinal stromal tumors mimics functional dyspepsia symptoms

Table 1 Pathological diagnoses of gastric submucosal lesions and their location

	Gastric fundus			Gastric body			Gastric antrum
	Muscularis mucosae	Submucosa	Muscularis	Muscularis mucosae	Submucosa	Muscularis	Muscularis mucosae	Submucosa	Muscularis
GIST (n = 67)			46			16	1		4
Leiomyoma (n = 38)			30			6			2
Neurilemmoma (n = 1)									1
Ectopic pancreas (n = 30)					1	2	8	13	6
Lipoma (n = 8)					3			5
Carcinoid (n = 4)						1	1		2
Inflammatory fibrous polyps (n = 9)							1	8
Others (n = 10)1						1	1	4
Total	0	2	76	0	4	26	12	30	15

¹Other lesions include vascular malformation, myoepithelial hamartoma, tuberculosis, lymphoma, and gastritis cystic profunda. GIST: Gastrointestinal tumor.

Table 2 Patient baseline features and endosonographic characteristics

	Leiomyoma(n = 38)	GIST(n = 67)	P value
Gender
Male	15	30	0.597
Female	23	37
Age (yr, mean ± SD)	51.73 ± 11.16	58.83 ± 8.52	0.001b
Tumor size (cm)
Median	1.00 ± 0.44	1.22 ± 0.22	0.057
Range	0.6-2.5	0.4-3
Intragastric location
Gastric antrum	2	5	0.525
Gastric body	6	16
Gastric fundus	30	46
Distribution in the gastric fundus
Proximal to cardia	24	14	< 0.001d
Distal to cardia	6	32
Site within gastric wall
Muscularis mucosae	0	1	0.449
Muscularis propria	38	66
Sonographic characteristics
Homogenous	36	50	0.010d
Hetrogenous with hyperechogenic spots	2	17
Echogenicity in comparison with the surrounding muscle echo
Isoechoic	38	54	0.004b
Hyperechoic	0	13
Margin of the tumor
Regular	37	61	0.212
Irregular	1	6

^bP < 0.01,

^dP < 0.001, leiomyoma group vs GIST group. GIST: Gastrointestinal tumor.

Table 3 Comparison of total gastrointestinal symptom scores of gastrointestinal tumors and leiomyomas before and after endoscopic submucosal dissection

	n	Pre-ESD	Post-ESD	P value
GIST	52	4.02 ± 2.54	1.34 ± 1.27	< 0.01
Leiomyoma	31	4.40 ± 2.81	2.20 ± 1.70	< 0.01
P value		0.57	0.043

ESD: Endoscopic submucosal dissection.

Table 4 Symptom distribution of gastrointestinal tumor and leiomyoma patients before and after endoscopic submucosal dissection

		Epigatric pain	Heartburn	Regurgitation	Discomfort	Nausea and vomiting	Bloating	Eructation
GIST	Pre- ESD	50% (26/52)	28.8% (15/52)	34.6% (18/52)	38.5% (20/52)	19.2% (10/52)	44.2% (23/52)	28.8% (15/52)
n = 52	Post- ESD	9.6%a (5/52)	11.5%a (6/52)	17.3%a (9/52)	26.9% (14/52)	3.8%a (2/52)	19.2%a (10/52)	17.3% (9/52)
Leiomyoma	Pre- ESD	38.7% (12/31)	32.2% (10/31)	32.2% (10/31)	64.5%c (20/31)	16.1% (5/31)	45.1% (17/31)	35.5% (11/31)
n = 31	Post- ESD	16.1% (5/31)	25.8% (8/31)	25.8% (8/31)	41.9% (13/31)	6.4% (2/31)	19.4%a (6/31)	16.1% (5/31)

^aP < 0.05 vs the same group before treatment;

^cP < 0.05 vs GIST group. GIST: Gastrointestinal tumor; ESD: Endoscopic submucosal dissection.

Table 5 Comparison between complete symptom resolution and unchanged health status after endoscopic submucosal dissection

	n	Resolved completely	Unchanged
GIST	52	13	2
Leiomyoma	31	5	5
P value		0.5	0.124

GIST: Gastrointestinal tumor.

Table 6 Comparison of symptom scores between gastrointestinal tumors and leiomyomas before and after endoscopic submucosal dissection

		Epigatric pain	Heartburn	Regurgitation	Discomfort	Nausea and vomiting	Bloating	Eructation
GIST	Pre ESD	0.80 ± 0.90	0.63 ± 1.08	0.55 ± 0.87	0.70 ± 0.98	0.27 ± 0.62	0.70 ± 0.90	0.36 ± 0.61
n = 52	Post ESD	0.13 ± 0.46a	0.13 ± 0.41a	0.22 ± 0.57a	0.32 ± 0.47a	0.05 ± 0.21a	0.27 ± 0.49a	0.21 ± 0.46a
Leiomyoma	Pre ESD	0.64 ± 0.86	0.60 ± 0.82	0.60 ± 0.82	1.00 ± 0.82	0.20 ± 0.50	1.00 ± 0.82	0.56 ± 0.92
n = 31	Post ESD	0.24 ± 0.52a	0.32 ± 0.56	0.32 ± 0.56a	0.52 ± 0.65a	0.08 ± 0.28	0.40 ± 0.64a	0.32 ± 0.69

^aP < 0.05 vs before treatment. ESD: Endoscopic submucosal dissection.