Nie WJ, Jing Z, Hua M. Value of enhanced computed tomography in differentiating small mesenchymal tumours of the gastrointestinal from smooth muscle tumours. World J Gastrointest Surg 2023; 15(9): 2012-2020 [PMID: 37901731 DOI: 10.4240/wjgs.v15.i9.2012]
Corresponding Author of This Article
Mo Hua, MD, Attending Doctor, Department of Radiology, Changzhou Geriatric Hospital Affiliated to Soochow University, Changzhou No. 7 People’s Hospital Radiology Department, No. 288 Yanling East Road, Changzhou 213011, Jiangsu Province, China. mohuafsk913044@sina.com
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 Gastrointest Surg. Sep 27, 2023; 15(9): 2012-2020 Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.2012
Value of enhanced computed tomography in differentiating small mesenchymal tumours of the gastrointestinal from smooth muscle tumours
Wen-Jun Nie, Zhao Jing, Mo Hua
Wen-Jun Nie, Mo Hua, Department of Radiology, Changzhou Geriatric Hospital Affiliated to Soochow University, Changzhou No. 7 People’s Hospital Radiology Department, Changzhou 213011, Jiangsu Province, China
Zhao Jing, Medical Area, Eastern Theater General Hospital, Qinhuai District Medical Area, Nanjing 210000, Jiangsu Province, China
Author contributions: Nie WJ and Hua M contributed equally to this work; Hua M designed the study; Zhao J contributed to the analysis of the manuscript; Nie WJ and Hua M were involved in the data and writing of this article; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the (Changzhou Geriatric Hospital Affiliated to Soochow University, Changzhou No. 7 People’s Hospital Radiology Department) Institutional Review Board.
Informed consent statement: All study participants and their legal guardians provide informed written consent before the study recruitment.
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: Mo Hua, MD, Attending Doctor, Department of Radiology, Changzhou Geriatric Hospital Affiliated to Soochow University, Changzhou No. 7 People’s Hospital Radiology Department, No. 288 Yanling East Road, Changzhou 213011, Jiangsu Province, China. mohuafsk913044@sina.com
Received: June 30, 2023 Peer-review started: June 30, 2023 First decision: July 18, 2023 Revised: July 24, 2023 Accepted: August 4, 2023 Article in press: August 4, 2023 Published online: September 27, 2023 Processing time: 84 Days and 3.8 Hours
Abstract
BACKGROUND
Computed tomography (CT) technology has been gradually used in the differentiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.
AIM
To explore the value of enhanced CT in the differentiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.
METHODS
Clinical data of patients with gastric mesenchymal or gastric smooth muscle tumours who were treated in our hospital from May 2018 to April 2023 were retrospectively analysed. Patients were divided into the gastric mesenchymal tumor group and the gastric smooth muscle tumor group respectively (n = 50 cases per group). Clinical data of 50 healthy volunteers who received physical examinations in our hospital during the same period were selected and included in the control group. Serum levels of carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), CA-125 and cytokeratin 19 fragment antigen 21-1 were compared among the three groups. The value of CEA and CA19-9 in the identification of gastric mesenchymal tumours was analysed using the receiver operating characteristic (ROC) curve. The Kappa statistic was used to analyse the consistency of the combined CEA and CA19-9 test in identifying gastric mesenchymal tumours.
RESULTS
CEA levels varied among the three groups in the following order: The gastric mesenchymal tumour group > the control group > the gastric smooth muscle tumour group. CA19-9 levels varied among the three groups in the following order: The gastric mesenchymal group > the gastric smooth muscle group > the control group, the difference was statistically significant (P < 0.05). ROC analysis showed that the area under the curve of CEA and CA19-9 was 0. 879 and 0. 782, respectively.
CONCLUSION
Enhanced CT has shown value in differentiating small mesenchymal tumors of the stomach and intestines from smooth muscle tumors.
Core Tip: Endoscopic ultrasound can accurately localise the lesion characteristics, and there are significant differences in the echogenic characteristics of intragastric mesenchymal tumours and smooth muscle tumours. In view of the fact that early metastases can occur in gastrointestinal mesenchymal tumours of less than 2 cm in diameter, endoscopic resection is recommended for the definitive diagnosis and simultaneous treatment or closer follow-up of intrinsic mesenchymal tumours with a clear echogenic border and less than 2 cm in diameter.
