Evaluation of gastric submucosal tumors using endoscopically visualized features with submucosal endoscopy

Area of Science:

• Gastroenterology
• Endoscopic Imaging
• Oncology

Background:

• Submucosal tumors (SMTs) require accurate diagnosis for appropriate management.
• Endoscopically visualized features (EVF) of SMTs have not been systematically evaluated for diagnostic potential.
• Differentiating gastrointestinal stromal tumors (GISTs) from benign submucosal tumors (BSTs) is clinically important.

Purpose of the Study:

• To investigate the diagnostic value of endoscopically visualized features (EVF) for gastric submucosal tumors (SMTs).
• To explore the potential of EVF in differentiating GISTs from BSTs.
• To propose a classification system for gastric SMTs based on EVF.

Main Methods:

• Retrospective review of EVF in 26 gastric SMT cases with confirmed pathological diagnosis.
• Classification of SMTs based on five EVF: color, clarity, shape, tumor coating, and solidity.
• Comparative evaluation of EVF between 13 low-risk GISTs and 13 BSTs.

Main Results:

• Similar EVF trends were observed between low-risk GISTs, granular cell tumors, and schwannomas.
• Leiomyomas tended to exhibit clear EVF, contrasting with cloudy EVF in other tumor types.
• Gastric GISTs showed a significantly higher frequency of a white, cloudy, and rigid EVF combination compared to BSTs (P<0.05).

Conclusions:

• Endoscopically visualized features (EVF) show potential for classifying gastric submucosal tumors (SMTs).
• EVF can aid in differentiating gastrointestinal stromal tumors (GISTs) from benign submucosal tumors (BSTs).
• A proposed EVF classification system may enhance diagnostic accuracy for gastric SMTs.