title: Internal hypoechoic feature by EUS as a possible predictive marker for the enlargement potential of gastric GI stromal tumors.
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.
  
  
  METHODS
  Single-center retrospective analysis.
  
  
  METHODS
  Academic university hospital in Japan.
  
  
  METHODS
  All patients (n = 74) with histologically diagnosed GISTs in the stomach underwent EUS.
  
  
  METHODS
  EUS.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Retrospective design of the study.
  
  
  CONCLUSIONS
  The internal hypoechoic area determined by EUS may be a predictor for the enlargement potential of gastric GISTs.
authors.affiliation: Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Onishi
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tominaga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sugimori
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Machida
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Okazaki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yamagami
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Watanabe
authors.forename: Toshio
authors.initials: T
authors.lastname: Watanabe
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Arakawa
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D018450:Disease Progression; D019160:Endosonography; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging* / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D047368:Tumor Burden