Preoperative diagnosis and prognosis of gastric stromal tumors using endoscopic ultrasonography

Objective: Accurate preoperative diagnosis and prognosis of a gastric stromal tumor is vital to its effective treatment. This study aimed to evaluate the value of endoscopic ultrasonography in gastric stromal tumor diagnosis and prognosis. Methods: We retrospectively analyzed 213 cases of gastric stromal tumor diagnosed preoperatively by endoscopic ultrasonography from June 2010 to June 2014, especially endoscopic ultrasonography results, and pathological findings. Results: The common locations included stomach fundus (n = 120), gastric body (n = 65), and sinuses ventriculi (n = 28). The patients’ symptoms were various. A definitive diagnosis depended on postoperative pathologic and immunohistochemical examination. The pathologic results showed that 63 of 213 cases (29.6%) were misdiagnosed by endoscopic ultrasonography. Tumor diameter, age, concurrent bleeding, and characteristics in endoscopic ultrasonography such as mucosal bridge and echo may have been the misdiagnosis factors, while lesion site, and characteristics like smooth surface, ulcer in the center, and boundary had nothing to do with misdiagnosis. Endoscopic ultrasonography characteristics including smooth surface and center ulcer were correlated with the malignant risk of gastric stromal tumor, but not uniformity echo, shape, mucosal bridge, and clear boundary. Conclusions: Endoscopic ultrasonography is a useful method to diagnose gastric stromal tumor with a misdiagnosis rate of 29.6%, and definite diagnosis relies on immunohistochemical analysis. Tumor diameter, age, concurrent bleeding, and characteristics in endoscopic ultrasonography such as mucosal bridge and echo may be misdiagnosis factors. Concurrent bleeding and endoscopic ultrasonography indexes of the smooth surface and center ulcer are potential prognostic factors of gastric stromal tumor.