1. Internal hypoechoic feature by EUS as a possible predictive marker for the enlargement potential of gastric GI stromal tumors
- Author
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Miho Onishi, Kenji Watanabe, Tetsuo Arakawa, Satoshi Sugimori, Kazunari Tominaga, Hirokazu Yamagami, Toshio Watanabe, Hirotoshi Okazaki, Yasuhiro Fujiwara, Hirohisa Machida, and Tetsuya Tanigawa
- Subjects
Male ,medicine.medical_specialty ,Gastrointestinal Stromal Tumors ,Gastroenterology ,Endosonography ,Predictive Value of Tests ,Stomach Neoplasms ,Internal medicine ,Gastroscopy ,Confidence Intervals ,Odds Ratio ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,High-power field ,Predictive marker ,GiST ,business.industry ,Stomach ,Retrospective cohort study ,Odds ratio ,Middle Aged ,digestive system diseases ,Confidence interval ,Tumor Burden ,medicine.anatomical_structure ,Predictive value of tests ,Multivariate Analysis ,Disease Progression ,Female ,business - Abstract
Background There is no clinical predictor for the enlargement potential of gastric GI stromal tumors (GISTs) during the follow-up observation period. Objective The aim of our study was to identify predictive markers for the enlargement potential of gastric GISTs on the basis of various endosonographic features determined at the initial examination. Design Single-center retrospective analysis. Setting Academic university hospital in Japan. Patients All patients (n = 74) with histologically diagnosed GISTs in the stomach underwent EUS. Intervention EUS. Main Outcome Measurements We analyzed the following endoscopic and EUS features: mucosal ulceration, irregular shape, irregular border, heterogeneity, internal hyperechoic spot, hypoechoic area, and anechoic area of gastric GISTs in 3 groups according to tumor size. Furthermore, we compared the characteristics between increased growth and unchanged growth of GISTs, that were defined on the basis of the novel tumor growth index: changes in tumor volume/follow-up interval (days between initial EUS and second EUS) (mm3/day). Results The presence of heterogeneity (P = .016) and anechoic area (P = .003) was significantly highest in the group with the largest tumor size. The increased growth group had a higher presence of hypoechoic area than did the unchanged growth group (84.2% vs 51.9%, P = .023). Multivariate analysis showed that the presence of a hypoechoic area was an enlargement-associated factor (odds ratio 5.38; 95% confidence interval 1.19-24.39; P = .029). Limitations Retrospective design of the study. Conclusions The internal hypoechoic area determined by EUS may be a predictor for the enlargement potential of gastric GISTs.
- Published
- 2012
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