Clinical Features and Factors Contributing to Preoperative Misdiagnosis of Gastric Gastrointestinal Stromal Tumors: A Retrospective Analysis of 27 Cases
For gastric submucosal protuberant lesions, a comprehensive EUS and CT imaging examination is necessary for accurate diagnosis to avoid misdiagnosis and inappropriate treatment, which may affect patient prognosis.
The study retrospectively analyzed 27 patients misdiagnosed preoperatively with gastric GISTs but ultimately diagnosed with non‑GIST gastric submucosal tumors or extragastric compressions. Clinical symptoms, computed tomography (CT) attenuation, and lesion size differed significantly between GISTs and non‑GISTs. The optimal arterial‑phase attenuation cutoff for distinguishing GISTs from non‑GISTs was ≤28.9 HU (AUC = 0.689), and a lesion size >3.4 cm was associated with GISTs (AUC = 0.766). Accurate preoperative evaluation using endoscopic ultrasound (EUS) and CT can prevent misdiagnosis and inappropriate treatment, thereby affecting patient prognosis.
Misdiagnosing gastric submucosal tumors as GISTs can lead to overtreatment with radical surgery or unnecessary systemic therapy, adversely impacting survival and quality of life. Accurate preoperative differentiation allows for tailored, less invasive management when appropriate.
Evidence level: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.
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