Clinical significance of endoscopic ultrasound for gastric submucosal tumors.
OBJECTIVE
Gastric submucosal tumors (SMTs) are often detected during routine gastroendoscopy but little is known about their natural history. The aim of this study was to evaluate the natural course of gastrointestinal mesenchymal tumors (GIMTs) in the stomach.


METHODS
From October 2001 to November 2011, a total of 228 gastric SMTs were evaluated by endoscopic ultrasonography (EUS). Based on the findings of EUS and enhanced CT, we diagnosed these tumors as lipomas, cysts, aberrant pancreases, extramural compressions, and GIMTs. The gastric GIMTs which were examined by EUS twice or more were included in this study and the factors associated with an increase in the size of gastric GIMTs were analyzed.


RESULTS
Fifty GIMTs were followed by EUS twice or more. The mean age was 66.4 ± 8.3 years old and the mean period of follow-up was 23.8 ± 21.7 months. Fourteen (28%) of 50 GIMTs increased in size and the time taken for gastric GIMTs to double in size was 19.1 ± 18.2 months. In multivariate logistic regression analysis, age (odds ratio [OR]=1.12, 95% confidence interval [CI]=1.03-1.21), non-upper area of the stomach (OR=5.08, 95%; CI=1.37-18.8) and the detection of an anechoic lesion on EUS (OR=5.90, 95%; CI=1.10-31.8) were the factors predicting an increase in size of gastric GIMTs.


CONCLUSIONS
We evaluated gastric SMTs by EUS and clarified the factors predicting the growth of gastric GIMT. EUS is indispensable for the diagnosis and management of gastric SMTs.
Department of Medicine and Clinical Oncology (K1), Graduate School of Medicine, Chiba University, Iohana 1-8-1, Chiba City, 260-8670 Japan.
Sachio
S
Hata
Makoto
M
Arai
Takuto
T
Suzuki
Daisuke
D
Maruoka
Tomoaki
T
Matsumura
Tomoo
T
Nakagawa
Tatsuro
T
Katsuno
Fumio
F
Imazeki
Osamu
O
Yokosuka
D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging* / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography