Endoscopic Ultrasonography For Diagnosis Of Gastric Stromal Tumors And Anlysis Of Different Risk Grades

Objective:(1)To retrospectively analyze the coincidence rate of Gastrointestinal stromal tumors(GISTs)between by Endoscopic ultrasonography(EUS)and by postoperative pathological diagnosis,and to discuss the risk factors about coincidence rate.(2)To analyze the EUS characteristics between different grades of gastric GISTs,and to analyze the risk factors of the classification of gastric GISTs.Methods:(1)Participants who were diagnosed with GISTs by EUS were included in our study,they also had.definite results of pathological diagnosis.We collected the baseline characteristic data(age,sex,surgical method)and the endoscopic ultrasonography image characteristics(the originating layer,the largest diameter of tumor,echo properties,boundary rules,mucous bridge,ulcers,liquefaction,calcification)of every participants.According to the postoperative pathological diagnosis,patients with positive EUS diagnosis were divided into the stromal tumor group and the non-stromal tumor group,and the coincidence rate of EUS diagnosis of gastric GISTs and postoperative pathological diagnosis was compared.Univariate analysis and Logistic multivariate regression were used to analyze the correlation between EUS characteristics and diagnostic coincidence rate.(2)Patients who were confirmed with gastric GISTs by pathological diagnosis were included in our study,All patients underwent EUS examination before surgery.We collected the baseline characteristic data and the endoscopic ultrasonography image characteristics of every participants.According to the NIH2008(modified version)standard,patients were divided into extremely low risk group,low risk group,moderate risk group,and high risk group,respectively.Univariate analysis and Logistic multivariate regression analysis were used to compare the difference and correlation of EUS characteristics in the distribution of gastric GISTs with different risk grades.Results:(1)In the participants who were diagnosed as gastric GISTs by endoscopic ultrasonography,106 cases were confirmed by postoperative pathology with a diagnostic accuracy of 67.1%.(2)The basic characteristic information of participants with positive postoperative pathology diagnosis was compared with that of patients with negative postoperative pathology diagnosis.he results showed that there were different in age,tumor diameter,mucosal bridge,level of origin,heterogeneity,liquefaction and calcification between participants with positive postoperative pathology diagnosis and participants with negative diagnosis.In gender,tumor location,surface ulcer,irregular boundary and echo characteristics,here was no difference between the two groups.(3)The results of unadjusted Logistic regression analysis showed that the results of EUS diagnosis were more likely to b consistent with the results of pathological diagnosis for participants over 60 years old,maximum diameter ranged from 1cm to 2 cm,participants with maximum diameter ranged from 2 cm to 5 cm,non-uniform internal echo,calcification,liquefaction,the results of EUS diagnosis were more likely to be consistent with the results of pathological diagnosis for participants with liquefaction,the OR are 4.00、2.33、2.67、3.25、2.49、4.308.In the Logistic regression analysis with adjustment for gender and age,the results of EUS diagnosis were more likely to be consistent with the results of pathological diagnosis for participants over 60 years old,the maximum diameter ranged from 2 cm to 5 cm,non-uniform internal echo,liquefaction,the results of EUS diagnosis were more likely to be consistent with the results of pathological diagnosis for participants with liquefaction,the OR are 4.23、2.70、3.30、4.51.(4)By comparing the characteristic data of different risk group of gastric GISTs,we found that there was difference among these group in tumor size,origin level,echo heterogeneity,unclear boundary,surface ulcer and liquefaction(P>0.05).However,there was no significant difference among these group in age,gender,tumor location,calcification and interlobular septum,the(5)The medium-risk and high-risk gastric GISTs were combined into the higher-risk gastric GISTs for further multivariate Logistic regression analysis.In the unadjusted Logistic regression analysis,GISTs with non-uniform echo,liquefaction and Surface ulcers the risk of developing higher-risk gastric GISTs increased,the OR are 4.00、2.33、2.67、3.25、2.49、4.308.In Logistic regression analysis with adjustment for gender and age,the risk of developing higher-risk gastric GISTs increased for participants with non-uniform echo,liquefaction and Surface ulcers,the OR are 7.19、4.06、5.59.Conclusions:(1)the coincidence rate of EUS diagnosis of gastric GISTs and post operative pathological diagnosis in our hospital was 67.1%.(2)For patients who over 60 years old,the maximum diameter ranged from 2 cm to 5 cm or with non-uniform echo and liquefaction,the results were more likely to be consistent with the results of pathological diagnosis.(3)For patients with non-uniform echo,liquefaction and Surface ulcers,the risk of developing higher-risk gastric GISTs increased.EUS has a high coincidence rate of diagnosis of gastric GISTs with postoperative pathology,and is an important examination for gastric GISTs.