Small bowel GISTs: clinicopathological patterns and the role of inflammatory markers

Vol. 66 No. 3, 2025

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Nicolae Dragos Margaritescu, Daniela Marinescu, Tiberiu Stefanita Tenea-Cojan, Liviu Vasile, Liliana Cercelaru, Gabriel Florin Razvan Mogos, Stelian Stefanita Mogoanta, Laurentiu Augustus Barbu

Background: Small bowel gastrointestinal stromal tumors (GISTs) are less common but more aggressive than gastric GISTs, and the prognostic relevance of inflammation-nutrition markers in this subgroup remains unclear. This study evaluated clinical, pathological, and inflammatory-nutritional profiles in patients with small bowel GISTs. Patients, Materials and Methods: We retrospectively analyzed 16 cases of small bowel GIST and assessed clinical features, tumor morphology, immunohistochemistry, and laboratory indices [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), red cell distribution width (RDW)]. Statistical correlations were examined using Spearman and Mann-Whitney tests. Results: Most tumors were large, frequently necrotic, and predominantly spindle-cell type; cluster of differentiation 117 (CD117) and discovered on GIST1 (DOG1) were positive in 93.8% of cases. Patients commonly presented with anemia, elevated inflammatory markers, and reduced PNI. Tumor size moderately correlated with NLR (rho=0.53). A strong inverse correlation was observed between PLR and PNI (rho=-0.686), and PNI was significantly lower in necrotic tumors (p=0.0498). No other significant associations emerged. Conclusions: Although inflammatory markers showed limited overall correlations, the PLR-PNI relationship and reduced PNI in necrotic tumors suggest that inflammation and nutritional decline may reflect tumor aggressiveness in small bowel GISTs. Larger studies are needed to confirm these findings.

Corresponding author: Liviu Vasile, Lecturer, MD, PhD; e-mail: vliviu777@yahoo.com; Gabriel Florin Razvan Mogos, Lecturer, MD, PhD; e-mail: gabriel.mogos@umfcv.ro

DOI: 10.47162/RJME.66.3.14 Download PDF
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