Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 458-468
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.458
Inflammation-related indicators to distinguish between gastric stromal tumors and leiomyomas: A retrospective study
Yu-Hao Zhai, Zhi Zheng, Wei Deng, Jie Yin, Zhi-Gang Bai, Xiao-Ye Liu, Jun Zhang, Zhong-Tao Zhang
Yu-Hao Zhai, Zhi Zheng, Wei Deng, Jie Yin, Zhi-Gang Bai, Xiao-Ye Liu, Jun Zhang, Zhong-Tao Zhang, Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Zhai YH, Zheng Z, Deng W and Yin J designed the research study; Zhai YH performed the research; Zhai YH and Bai ZG contributed new reagents and analytic tools; Zhai YH, Liu XY, Zhang J and Zhang ZT analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Supported by Beijing Municipal Science & Technology Commission, No. D17100006517003; and Beijing Municipal Administration of Hospitals Incubating Program, No. PX2020001.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Institute of Friendship Hospital, Capital Medical University Institutional Review Board.
Informed consent statement: Patients were not required to provide informed consent to the study because this was a retrospective study and only analyzed the clinical data of the patients. All patient data were analyzed after anonymization.
Conflict-of-interest statement: The authors declare no conflicts of interest in this work.
Data sharing statement: Some or all data, models, or code generated or used during the study are available from the corresponding author by request. People could contact one of the authors to get the data which is not used for commercial purposes.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Zhang, MD, PhD, Chief Doctor, Director, Surgeon, Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China. zhangjun5986@ccmu.edu.cn
Received: July 19, 2021
Peer-review started: July 19, 2021
First decision: October 16, 2021
Revised: October 20, 2021
Accepted: December 2, 2021
Article in press: December 2, 2021
Published online: January 14, 2022
ARTICLE HIGHLIGHTS
Research background

Gastric leiomyoma and gastrointestinal stromal tumor are common tumors in the gastric mucosa. The two types of tumors are difficult to differentiate in the initial diagnosis. Inflammation-related indicators reflect the status of inflammation, which could distinguish two kinds of tumors.

Research motivation

A predictive model was constructed based on the nomogram to clarify the kind of tumors, which may help us figuring out tumor microenvironment of gastric stromal tumor. The paper will be the basis of the further research.

Research objectives

The purpose is to explore the differences in platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), lymphocyte mononuclear cell ratio (LMR), and SII between the two types of tumors, clarify the relationship and find which is the most important factor in that.

Research methods

Of 88 patients in the gastric stromal tumor group and 56 patients in the gastric leiomyoma group were enrolled into this study, and the relevant data of the two groups were entered into the system for integrated analysis. Nomogram was used to create a predictive model for that. Subgroup analysis was carried out to prove the presence of difference in low-risk stromal tumors.

Research results

The two groups were in PLR (158.2 vs 134.3, P = 0.028), NLR (2.35 vs 1.68, P = 0.000), LMR (5.75 vs 10.8, P = 0.004), SII (546.2 vs 384.3, P = 0.003) showed statistical differences. The results of the subsequent multivariate Logistic regression analysis showed that gender, age, tumor location, and LMR were independent risk factors for the identification of the two types of tumors. Nomogram model and calibration plot was constructed and subgroup analysis showed that LMR and NLR seems more sensitive than PLR and SII.

Research conclusions

It is the first time to find that inflammation-related indicators are different between gastric stromal tumors and leiomyomas, which provides us a new method to differentiate them.

Research perspectives

Further research need to be conducted to explain the reason of the the difference, and combine other examinations, such as computed tomography, to create an appropriate model for that.