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  • Title: Internal hypoechoic feature by EUS as a possible predictive marker for the enlargement potential of gastric GI stromal tumors.
    Author: Onishi M, Tominaga K, Sugimori S, Machida H, Okazaki H, Yamagami H, Tanigawa T, Watanabe K, Watanabe T, Fujiwara Y, Arakawa T.
    Journal: Gastrointest Endosc; 2012 Apr; 75(4):731-8. PubMed ID: 22281109.
    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) (mm(3)/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.
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