Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 458-468
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.458
Inflammation-related indicators to distinguish between gastric stromal tumors and leiomyomas: A retrospective study
Yu-Hao Zhai, Zhi Zheng, Wei Deng, Jie Yin, Zhi-Gang Bai, Xiao-Ye Liu, Jun Zhang, Zhong-Tao Zhang
Yu-Hao Zhai, Zhi Zheng, Wei Deng, Jie Yin, Zhi-Gang Bai, Xiao-Ye Liu, Jun Zhang, Zhong-Tao Zhang, Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Zhai YH, Zheng Z, Deng W and Yin J designed the research study; Zhai YH performed the research; Zhai YH and Bai ZG contributed new reagents and analytic tools; Zhai YH, Liu XY, Zhang J and Zhang ZT analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Supported by Beijing Municipal Science & Technology Commission, No. D17100006517003; and Beijing Municipal Administration of Hospitals Incubating Program, No. PX2020001.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Institute of Friendship Hospital, Capital Medical University Institutional Review Board.
Informed consent statement: Patients were not required to provide informed consent to the study because this was a retrospective study and only analyzed the clinical data of the patients. All patient data were analyzed after anonymization.
Conflict-of-interest statement: The authors declare no conflicts of interest in this work.
Data sharing statement: Some or all data, models, or code generated or used during the study are available from the corresponding author by request. People could contact one of the authors to get the data which is not used for commercial purposes.
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: Jun Zhang, MD, PhD, Chief Doctor, Director, Surgeon, Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China. zhangjun5986@ccmu.edu.cn
Received: July 19, 2021
Peer-review started: July 19, 2021
First decision: October 16, 2021
Revised: October 20, 2021
Accepted: December 2, 2021
Article in press: December 2, 2021
Published online: January 14, 2022
Abstract
BACKGROUND

Gastric leiomyomas and gastric stromal tumors are the most common types of gastric tumors encountered. In recent years, the incidence of the two types of tumors has been increasing, but the differential diagnosis is still a challenge in clinical work. However, as there are many reports on stromal tumors and inflammation-related indicators are gradually being paid attention to as important factors in predicting tumor prognosis, the two main purposes of this study were to explore the inflammation-related differences between the two types of tumors and to develop a nomogram as a predictive model.

AIM

To explore the differences in platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), lymphocyte mononuclear cell ratio (LMR), and SII between the two types of tumors, and simultaneously create the nomogram model.

METHODS

This study enrolled 88 patients in the gastric stromal tumor group and 56 patients in the gastric leiomyoma group, and the relevant data of the two groups were entered into the system for an integrated analysis. The primary objective of this study was to identify the differences in the inflammation index between the two types of tumors.

RESULTS

There were statistically significant differences between the two groups in sex, age, and tumor location. In comparison, gastric leiomyomas seem to be more common in women, young patients, and gastric cardia, which is in line with our previous research; the groups showed the following statistical differences: PLR (158.2% vs 134.3%, P = 0.028), NLR (2.35 vs 1.68, P = 0.000), LMR (5.75 vs 10.8, P = 0.004), and SII (546.2 vs 384.3, P = 0.003). The results of the multivariate logistic regression analysis showed that sex, age, tumor location, and LMR were independent risk factors for the identification of the two types of tumors. After considering the risk factors selected by the above analysis into the predictive model, a predictive model for distinguishing gastrointestinal stromal tumors from gastric leiomyomas was established as the nomogram.

CONCLUSION

Gastric leiomyomas and gastric stromal tumors are not only different in factors such as age of the patient, but also in inflammatory indicators such as LMR and PLR. We have established a predictive model related to the laboratory indicators and are looking forward to further research conducted in this clinical area.

Keywords: Gastric leiomyoma, Gastrointestinal stromal tumor, Platelet-lymphocyte ratio, Neutrophil-lymphocyte ratio, Lymphocyte mononuclear cell ratio, SII, Nomogram

Core Tip: We found that inflammation-related factors such as platelet-lymphocyte ratio and neutrophil-lymphocyte ratio were different in patients with gastrointestinal stromal tumors and leiomyomas, which also reflected the different inflammatory status between them. Meanwhile, this study constructed a relevant differential diagnosis model through a nomogram and evaluated its accuracy, which may be helpful for future studies.