Researchers identified factors that could predict gastric subepithelial tumors such as gastrointestinal stromal tumors (GISTs) preoperatively, as published in the Journal of Personalized Medicine. Patients diagnosed with GISTs were usually older, had low hemoglobin levels, and showed tumor necrosis on computed tomography (CT).

“The clinical findings and preoperative image findings could help predict diagnosis, which could assist surgeons in treatment planning before operation and other management,” they said.

Predicting preoperative gastric subepithelial tumors has been shown to be difficult. Here, a team of researchers led by Keng-Hao Liu, MD, from the Department of General Surgery at Linkou Chang Gung Memorial Hospital in Taoyuan, Taiwan conducted a retrospective review of 395 patients who underwent surgery to treat their gastric subepithelial tumors including GISTs, leiomyomas, and schwannomas measuring 2 cm to 10 cm in diameter.

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The researchers grouped the tumors by size. In the first group, they included tumors measuring more than 2 cm up to 5 cm in diameter, and in the second, they included those measuring more than 5 cm and up to 10 cm in diameter. They analyzed patients’ demographic characteristics, clinical symptoms, and images obtained through CT.

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The results showed that patients with GISTs were relatively older than patients with leiomyomas or schwannomas. They also had higher proportions of upper gastrointestinal tract bleeding regardless of tumor size, lower hemoglobin levels, and a higher ratio of necrosis. 

Using a recursive partitioning analysis, the researchers found that being aged 55 years or younger and having hemoglobin levels of 10.7 or higher and necrosis in CT scan could predict a high risk of GISTs in patients with tumors measuring 2 cm to 5 cm. 

Similarly, being aged 55 years or younger and having hemoglobin levels lower than 10.7 could also predict a high risk of GISTs in patients with tumors of that size. For patients older than 55 years, hemoglobin levels lower than 12.9  and hetero-/homogeneity in CT, could predict a high risk of GISTs in the case of tumors measuring between 2 cm and 5 cm.

In patients with tumors measuring between 5 cm and 10 cm, aged above 55 years, and positive or negative CT, necrosis could predict a high risk of GIST. The accuracy of the recursive partitioning analysis reached 85% in patients with smaller tumors and 89% in those with larger tumors.


Lin YN, Chen MY, Tsai CY, et al. Prediction of gastric gastrointestinal stromal tumors before operation: a retrospective analysis of gastric subepithelial tumors. J Pers Med. 2022;12(2):297. doi:10.3390/jpm12020297