Long-Term Outcomes of Gastric Subepithelial Lesion of < 2 cm and Risk Factors for Tumor Growth.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology Pub Date : 2025-05-23 DOI:10.1111/jgh.17019

Miyuki Iwasaki, Tomoaki Matsumura, Kenichiro Okimoto, Yuhei Ohyama, Yukiyo Mamiya, Hayato Nakazawa, Satsuki Takahashi, Ryosuke Horio, Chihiro Goto, Michiko Sonoda, Akane Kurosugi, Tatsuya Kaneko, Yuki Ohta, Takashi Taida, Keisuke Matsusaka, Yoshihito Ozawa, Koichi Hayano, Jun Kato, Hisahiro Matsubara, Naoya Kato

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引用次数: 0

Abstract

Background and aim: Endoscopic resection of small gastric subepithelial lesions (SELs) has been recently reported. However, evidence of natural history of untreated small gastric SELs is lacking. This study aimed to investigate the long-term course of gastric SELs of < 2 cm as well as identify the enlargement rate and factors affecting it.

Methods: A total of 1045 gastric SELs in 1033 patients were evaluated via endoscopic ultrasonography (EUS) from January 1994 to December 2023. Of these, this study included 125 SELs in 122 patients with an initial tumor diameter of < 2 cm and who underwent at least two EUS examinations. Tumor diameter was measured through EUS and considered enlarged when the longitudinal diameter increased > 1.25 times from the initial size. Multivariate Cox proportional hazards regression analysis was used to identify factors affecting tumor enlargement.

Results: The average observation period was 4.0 ± 3.4 years. A total of 29 (23.2%) lesions were enlarged during the observation period, with a mean tumor doubling time of 4.1 ± 3.8 years and an augmentation rate of 5.7/100 person-years. The multivariate analysis indicated that the initial tumor size of ≥ 9.5 mm (hazard ratio [HR]: 3.99, 95% confidence interval [CI]: 1.33-11.94) and EUS finding changes (irregular border, cystic space, high echoic lesion, and/or heterogeneity), excluding calcifications (HR: 2.55, 95% CI: 1.09-5.97), were increasing factors.

Conclusions: The augmentation rate of gastric SELs of < 2 cm was 5.7/100 person-years. These results provide valuable data for treatment decisions.

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< 2cm胃上皮下病变的远期预后及肿瘤生长的危险因素。

背景和目的：内镜下切除胃上皮下小病变（SELs）最近有报道。然而，缺乏未经治疗的胃小SELs的自然史证据。方法：1994年1月至2023年12月，对1033例患者的1045例胃SELs进行超声内镜（EUS）检查。其中，本研究纳入了122例初始肿瘤直径为初始肿瘤大小1.25倍的125例SELs患者。采用多因素Cox比例风险回归分析确定影响肿瘤增大的因素。结果：平均观察期4.0±3.4年。观察期内共发生肿大29例（23.2%），肿瘤平均倍增时间4.1±3.8年，增大率5.7/100人年。多因素分析显示，初始肿瘤大小≥9.5 mm（风险比[HR]: 3.99, 95%可信区间[CI]: 1.33-11.94）和EUS发现的变化（边界不规则、囊性间隙、高回声病变和/或异质性）是增加因素，不包括钙化（HR: 2.55, 95% CI: 1.09-5.97）。结论：大鼠胃sel增强率

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.40%

发文量

326

审稿时长

2.3 months

期刊介绍： Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.