Small bowel GISTs: clinicopathological patterns and the role of inflammatory markers

Small bowel gastrointestinal stromal tumors (GISTs) are less common but more aggressive than gastric GISTs, and the prognostic relevance of inflammation-nutrition markers in this subgroup remains unclear. This study evaluated clinical, pathological, and inflammatory-nutritional profiles in patients with small bowel GISTs.

We retrospectively analyzed 16 cases of small bowel GIST and assessed clinical features, tumor morphology, immunohistochemistry, and laboratory indices [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), red cell distribution width (RDW)]. Statistical correlations were examined using Spearman and Mann-Whitney tests.

Most tumors were large, frequently necrotic, and predominantly spindle-cell type; cluster of differentiation 117 (CD117) and discovered on GIST1 (DOG1) were positive in 93.8% of cases. Patients commonly presented with anemia, elevated inflammatory markers, and reduced PNI. Tumor size moderately correlated with NLR (ρ=0.53). A strong inverse correlation was observed between PLR and PNI (ρ=-0.686), and PNI was significantly lower in necrotic tumors (p=0.0498). No other significant associations emerged.

Although inflammatory markers showed limited overall correlations, the PLR-PNI relationship and reduced PNI in necrotic tumors suggest that inflammation and nutritional decline may reflect tumor aggressiveness in small bowel GISTs. Larger studies are needed to confirm these findings.