The Value Of CE-EUS In The Treatment Decision Of Gastric Stromal Tumor

Background and objective:Gastric stromal tumors were classified into medium-to-high risk and extremely low/low risk,while there were different treatment methods for different risk level of gastric stromal tumors.Therefore,accurate judgment of gastric stromal tumors risk levels in vivo will directly affect their treatment decisions.In this study,we performed a retrospective study of CE-EUS inspection result and pathological diagnosis about cases of gastric stromal tumors in our hospital,so that we can determine the role of CE-EUS in the risk assessment of gastric stromal tumors and explore its value in the treatment decision of gastric stromal tumors.Methods:Totally 23 cases with gastric stromal tumor were enrolled in this study from the Department of Gastroenterology,the Second Clinical Medical College of Jinan University(Longhua Branch of Shenzhen People’s Hospital)from May 2016 to February 2022.We collected their demographic datas,EUS and CE-EUS test,postoperative pathology and immunohistochemistry result for statistically analyzed.Results:The age of the 23 patients ranged from 32 to 73 years old,with an average age of50.26±11.6 years old,including 9 males and 14 females.There was no correlation between age and sex and the risk grade of stromal tumors(P > 0.05).The tumor size ranged from 4.2mm to61 mm,including 15 cases located in gastric fundus,7 cases in gastric body,1 case in gastric antrum,and only 3 cases had ulcers on the surface.The analysis showed that tumor size and ulcer on the surface were related to the risk grade of stromal tumor(P < 0.05),while tumor heterogeneity and location could not be used as independent predictors(P > 0.05).By CE-EUS examination,6 cases showed enhancement,of which 5 cases were confirmed as high risk by pathology,the other was low risk,and 17 cases showed no enhancement,all of which were low risk.The sensitivity,specificity,positive predictive value and negative predictive value of CE-EUS were 100%,94.4%,83.3% and 100%,respectively,in the diagnosis of high-risk stromal tumors based on enhancement.In addition,whether CE-EUS enhancement was correlated with tumor size and tumor surface ulcer(all P < 0.05).Conclusion:CE-EUS is an effective measure to judge the risk level of gastric stromal tumor,and clinical treatment strategies can be formulated according to whether the gastric stromal tumor is enhanced in CE-EUS.If the tumor has no enhancement signs,it is suggested that the stromal tumor is a very/low-risk stromal tumor,and endoscopic resection or follow-up observation can be performed at this time.If there is enhancement,it is highly suggestive of intermediate/high risk stromal tumor,and prompt surgical resection is recommended.