Prevalence and natural course of incidental gastric subepithelial tumors

Abstract

The prevalence of gastric SETs increases with age. Most gastric SETs do not progress during long-term endoscopic examinations, and the risk of an increase in size is low in asymptomatic small SETs without irregular borders.Background/Aims: Gastric subepithelial tumors (SETs) are often encountered during the upper gastrointestinal endoscopic screening.We assessed the prevalence of gastric SETs and the risk factors for their progression. Methods: We reviewed the electronic medical records of 30,754 patients who underwent upper gastrointestinal endoscopic screening at our medical center between January 2013 and December 2016.Results: Among the 30,754 patients examined, 599 (1.9%) had gastric SETs. The prevalence increased with age and was 9.56% in patients aged ≥70 years. In total, 262 patients underwent serial endoscopy for more than 6 months. The median age was 68 years (interquartile range [IQR], 61-74), and the number of females was 167 (63.7%). During a median follow-up of 58 months (IQR, 38-75), 22 patients (8.4%) showed significant changes in tumor size. An irregular border (odds ratio, 4.623; 95% confidence interval, 1.093-19.558; p=0.037) was a significant risk factor for progression. Seven patients underwent surgical or endoscopic resections. The pathologies of gastric SETs included leiomyomas (n=3), gastrointestinal stromal tumors (n=2), and lipomas (n=2). Conclusions:The prevalence of gastric SETs increases with age. Most gastric SETs do not progress during long-term endoscopic examinations, and the risk of an increase in size is low in asymptomatic small SETs without irregular borders.

Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis

“…Subepithelial tumors (SETs) are frequently coincidentally discovered during endoscopic examinations of the gastrointestinal (GI) tract. The frequency of upper GI SETs is reported to be 1.6−1.9%; approximately two-thirds of upper GI SETs are present in the stomach [1,2]. Among gastric SETs, gastric mesenchymal tumors originating from the muscularis propria are of major concern in clinical practice.…”