Li XL, Han PF, Wang W, Shao LW, Wang YW. Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps, and gastric stromal tumor risk stratification assessment. World J Gastrointest Oncol 2022; 14(10): 2004-2013 [PMID: 36310702 DOI: 10.4251/wjgo.v14.i10.2004]
Corresponding Author of This Article
Ying-Wei Wang, PhD, Attending Doctor, Diagnostic Radiology Department, The first medical center of PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. wangyw301@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
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 Gastrointest Oncol. Oct 15, 2022; 14(10): 2004-2013 Published online Oct 15, 2022. doi: 10.4251/wjgo.v14.i10.2004
Table 1 National Institutes of Health evaluation criteria for gastric stromal tumor pathological risk
GST Hazard classification
Lesion diameter (cm)
Mitosis (/50HPF)
Primary tumor location
Very low risk
< 2.0
≤ 5.0
Any position
Low risk
2.1 - 5.0
≤ 5.0
Any position
Medium risk
2.1 - 5.0
> 5.0
Stomach
< 5.0
6.0 - 1.0
Any position
5.0 - 10.0
≤ 5.0
Stomach
High risk
Any case
Any case
Tumor rupture
> 10.0
Any case
Any position
Any case
> 10.0
Any position
> 5.0
> 5.0
Any position
2.1 - 5.0
> 5.0
Non-stomach
5.0 - 10.0
≤ 5.0
Non-stomach
Table 2 Comparison of baseline data between gastric stromal tumor group and control group, n (%)
Normal information
GST group (n = 64)
Control group (n = 60)
t/χ2 value
P value
Age (yr)
56.9 ± 8.2
59.0 ± 7.5
-1.485
0.140
BMI (kg/m2)
24.7 ± 2.4
24.4 ± 2.3
0.710
0.479
Lesion diameter (cm)
2.98 ± 0.77
3.05 ± 0.80
-0.496
0.620
Gender
1.542
0.214
Male
37 (57.81)
28 (46.67)
Female
27 (42.19)
32 (53.33)
Smoking
1.663
0.197
Yes
24 (37.5)
16 (26.67)
No
40 (62.5)
44 (73.33)
Drinking
1.592
0.207
Yes
25 (39.06)
17 (28.33)
No
39 (60.94)
43 (71.67)
Diabetes
0.776
0.378
Yes
9 (14.06)
12 (20.00)
No
55 (85.94)
48 (80.00)
Hypertension
2.940
0.086
Yes
15 (23.44)
7 (11.67)
No
49 (76.56)
53 (88.33)
Table 3 Comparison of computed tomography signs and parameters between gastric stromal tumor group and control group, n (%)
CT signs
GST group (n = 64)
Control group (n = 60)
χ2 value
P value
Lesion location
4.174
0.383
Fundus of stomach
12 (18.75)
14 (23.33)
Cardia
6 (9.38)
8 (13.33)
Greater curvature of the stomach
26 (40.63)
17 (28.33)
Lesser curvature of stomach
11 (17.19)
7 (11.67)
Gastric antrum
9 (14.06)
14 (23.33)
Tumor shape
3.228
0.072
Smooth
50 (78.13)
54 (90.00)
Lobulated
14 (21.88)
6 (10.00)
Growth pattern
41.177
0.000
Intraluminal
22 (34.38)
54 (90.00)
Extraluminal
32 (50.00)
6 (10.00)
Mixed way
10 (15.63)
0 (0.00)
Calcification
1.166
0.280
Yes
5 (7.81)
2 (3.33)
No
59 (92.19)
58 (96.67)
Lesion border
31.312
0.000
Clear
11 (17.19)
40 (66.67)
Blurry
53 (82.81)
20 (33.33)
Reinforcement
3.725
0.054
Uniform
54 (84.38)
57 (95.00)
Uneven
10 (15.63)
3 (5.00)
Ulcer
9.771
0.002
Yes
18 (28.13)
4 (6.67)
No
46 (71.88)
56 (93.33)
Table 4 Comparison of computed tomography values between gastric stromal tumor group and control group (mean ± SD, HU)
Groups
n
Arterial phase
Venous phase
Delay period
Reinforcement peak
GST group
64
63.98 ± 14.38
59.04 ± 12.74
66.58 ± 11.47
75.58 ± 12.88
Control group
60
47.61 ± 11.04
56.48 ± 14.20
64.72 ± 9.83
64.46 ± 10.94
t value
-7.137
-1.054
-0.971
-5.192
P value
0.000
0.294
0.333
0.000
Table 5 Multi-slice spiral computed tomography differential diagnosis of gastric stromal tumor and gastric polyps 2 × 2 four-table table
MSCT
Pathology
Total
GST
Benign polyp
GST
47
10
57
Benign polyp
17
50
67
Total
64
60
124
Table 6 Comparison of computed tomography sign parameters in gastric stromal tumor groups with different risk classes, n (%)
CT signs
Low-intermediate-risk group (n = 41)
High-risk group (n = 23)
χ2 value
P value
Lesion location
2.180
0.703
Fundus of stomach
7 (17.07)
5 (21.74)
Cardia
4 (9.76)
2 (8.70)
Greater curvature of the stomach
15 (36.59)
11 (47.83)
Lesser curvature of stomach
9 (21.95)
2 (8.70)
Gastric antrum
6 (14.63)
3 (13.04)
Tumor shape
1.539
0.215
Smooth
34 (82.93)
16 (69.57)
Lobulated
7 (17.07)
7 (30.43)
Growth pattern
5.520
0.063
Intraluminal
17 (41.46)
5 (21.74)
Extraluminal
16 (39.02)
16 (69.57)
Mixed way
8 (19.51)
2 (8.70)
Calcification
0.039
0.844
Yes
3 (7.32)
2 (8.70)
No
38 (92.68)
21 (91.3)
Lesion border
4.158
0.041
Clear
10 (24.39)
1 (4.35)
Blurry
31 (75.61)
22 (95.65)
Reinforcement
0.181
0.670
Uniform
34 (82.93)
20 (86.96)
Uneven
7 (17.07)
3 (13.04)
Ulcer
4.187
0.041
Yes
8 (19.51)
10 (43.48)
No
33 (80.49)
13 (56.52)
Table 7 Comparison of computed tomography values of patients in gastric stromal tumor groups with different risk classes (mean ± SD)
Group
n
Arterial phase
Venous phase
Delay period
Reinforcement peak
Low-intermediate-risk group
41
55.71 ± 13.77
57.94 ± 12.51
64.83 ± 11.20
72.66 ± 12.46
High-risk group
23
78.72 ± 12.66
61.00 ± 11.96
69.70 ± 10.85
80.79 ± 12.37
t value
-6.598
-0.954
-1.688
-2.511
P value
0.000
0.344
0.097
0.015
Citation: Li XL, Han PF, Wang W, Shao LW, Wang YW. Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps, and gastric stromal tumor risk stratification assessment. World J Gastrointest Oncol 2022; 14(10): 2004-2013