The clinical value of endoscopic ultrasonography combined with inflammatory markers in the differential diagnosis of gastric stromal tumor and gastric leiomyoma

Xu Yanan; Ma Xiaoyu; Xi Jinxing; Zheng Ya; Wang Yuping; Ji Rui

doi:10.3760/j.issn.1673-4777.2025.08.008

Abstract：Objective To explore the clinical value of endoscopic ultrasonography combined with inflammatory markers in the differential diagnosis of gastric stromal tumor and gastric leiomyoma.Methods From January 2017 to April 2024,at the Department of Gastroenterology,the First Hospital of Lanzhou University,the clinical data of 152 patients who underwent endoscopic treatment and were confirmed as gastric stromal tumor or leiomyoma by postoperative pathology were retrospectively selected.There were 86 cases of gastric stromal tumor(gastric stromal tumor group)and 66 cases of gastric leiomyoma(gastric leiomyoma group).The baseline data,endoscopic ultra-sound characteristics and inflammation-related indicators of the two groups were compared.Binary Logistic regres-sion was used to analyze the independent diagnostic factors of gastric stromal tumor and gastric leiomyoma.The receiver operating characteristic curve was used to analyze the diagnostic efficacy of single index and combination for gastric stromal tumor and gastric leiomyoma.Results The age of patients in gastric stromal tumor group was significantly older than that in gastric leiomyoma group[58(53,64)years vs 54(47,59)years](Z=-3.438,P=0.001).There were significant differences in tumor size,tumor location,internal echo properties and echo uniformity between the two groups(all P＜0.05).The platelet to lymphocyte ratio(PLR)and neutrophil to lymphocyte ratio in gastric leiomyoma group were lower than those in gastric stromal tumor group,and the lympho-cyte to monocyte ratio(LMR)was higher than that in gastric stromal tumor group(all P＜0.05).Multivariate binary Logistic regression analysis showed that age,tumor size,tumor location,PLR and LMR were independent diagnostic factors(all P＜0.05).The results of receiver operating characteristic curve analysis showed that the area under the curve of age,tumor size,tumor location,PLR,LMR and the combination of the five indicators were 0.337,0.309,0.424,0.378,0.670,0.856,respectively.The diagnostic efficacy of the combination of the five indicators for gastric stromal tumor and gastric leiomyoma was significantly better than that of each single indicator.Conclusion The combined model of endoscopic ultrasonography features and inflammatory indicators can significantly improve the efficacy of preoperative differential diagnosis of gastric stromal tumors and gastric leiomyoma,and provide a reliable basis for clinical diagnosis.