Researchers in Korea have identified several factors that could differentiate between gastrointestinal stromal tumors (GISTs) and leiomyomas of the stomach.  

Age, sex, homogeneity, location of the tumor, and the presence of anechoic spaces, dimpling, or ulcers on an endoscopic ultrasonography are factors that can facilitate the difference between the 2 diseases. This is according to a new study published in the journal Clinical Endoscopy.

Sun Moon Kim, MD, PhD, from the Department of Internal Medicine at Konyang University College of Medicine in Daejeon, Korea, and the coauthors of the study reached this conclusion after reviewing the medical records of 274 patients with GIST and 87 patients with leiomyomas.


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The researchers collected data on patient demographics and tumor characteristics, including location shape and growth pattern, as well as the presence of dimpling or ulcer, mucosal erythema, and lobulation. They selected predictive factors and constructed a predictive model and nomogram.

Read more about GIST diagnosis

Statistical analyses identified tumor heterogeneity, noncardia location, and older age as independent predictors of GISTs.

GISTs are soft tissue sarcomas that arise along the gastrointestinal tract, most often in the stomach, usually due to a mutation in the c-KIT proto-oncogene. Gastric leiomyomas are tumors found in the stomach that originate from the muscular propria or lamina muscularis mucosae.  

Because leiomyomas are benign and GISTs are potentially malignant, it is essential to differentiate between them so an effective clinical management approach can be adopted. 

Endoscopic ultrasonography can help differentiate GISTs and benign lesions and can be useful for narrowing down the differential diagnoses of subepithelial tumors. However, it is unable to provide a conclusive diagnosis. The current study creates a predictive risk score model and nomogram that allows the differentiation of gastric GISTs and leiomyomas.

Reference

Kim SM, Kim EY, Cho JW, et al. Predictive factors for differentiating gastrointestinal stromal tumors from leiomyomas based on endoscopic ultrasonography findings in patients with gastric subepithelial tumors: a multicenter retrospective study. Clin Endosc. Published online November 18, 2021. doi:10.5946/ce.2021.251