Gu YC, Yang TY, Zhu K, Zhao CL, Zang XJ, Xie YD. Predictive value of multi-slice spiral computed tomography tumor diameter and necrotic ratio for very high-risk gastrointestinal stromal tumors. World J Gastrointest Surg 2026; 18(10): 121503 [DOI: 10.4240/wjgs.121503]
Corresponding Author of This Article
Ying-Di Xie, Associate Chief Physician, Research Fellow, Department of Radiology, Binhai County People’s Hospital; Jiangsu Vocational College of Medicine, No. 299 Binhai Seaside Avenue, Yancheng 224500, Jiangsu Province, China. xieyingdi2020@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Gu YC, Yang TY, Zhu K, Zhao CL, Zang XJ, Xie YD. Predictive value of multi-slice spiral computed tomography tumor diameter and necrotic ratio for very high-risk gastrointestinal stromal tumors. World J Gastrointest Surg 2026; 18(10): 121503 [DOI: 10.4240/wjgs.121503]
Yang-Chun Gu, Tian-Yu Yang, Ke Zhu, Xiao-Jin Zang, Ying-Di Xie, Department of Radiology, Binhai County People’s Hospital; Jiangsu Vocational College of Medicine, Yancheng 224500, Jiangsu Province, China
Cheng-Li Zhao, Department of Gastroenterology, Binhai County People’s Hospital; Jiangsu Vocational College of Medicine, Yancheng 224500, Jiangsu Province, China
Co-first authors: Yang-Chun Gu and Tian-Yu Yang.
Co-corresponding authors: Xiao-Jin Zang and Ying-Di Xie.
Author contributions: Gu YC and Yang TY contributed equally to study design, data collection and manuscript drafting and they contribute equally to this study as co-first authors; Zang XJ and Xie YD supervised the research and revised the manuscript and they contribute equally to this study as co-corresponding authors; Zhu K and Zhao CL participated in data analysis; and all authors approved the final manuscript.
AI contribution statement: No AI tools were utilized in drafting, data analysis or revision of this manuscript. All contents were independently completed by authors, who bear full responsibility for the integrity and accuracy of the whole work.
Supported by Jiangsu Medical Vocational College Yancheng Health Commission Collaborative Innovation Research Project, No. 202491013.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Binhai County People’s Hospital (Approval No. 2025BYKYLL030).
Informed consent statement: All study participants and their legal guardians provided written informed consent before recruitment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Corresponding author: Ying-Di Xie, Associate Chief Physician, Research Fellow, Department of Radiology, Binhai County People’s Hospital; Jiangsu Vocational College of Medicine, No. 299 Binhai Seaside Avenue, Yancheng 224500, Jiangsu Province, China. xieyingdi2020@163.com
Received: April 24, 2026 Revised: June 11, 2026 Accepted: June 26, 2026 Published online: October 27, 2026 Processing time: 176 Days and 7.4 Hours
Abstract
BACKGROUND
Accurate preoperative risk stratification of gastrointestinal stromal tumors (GISTs) is essential for individualized treatment planning and prognostic evaluation. However, reliable non-invasive imaging biomarkers for identifying very high-risk GISTs remain limited.
AIM
To evaluate multi-slice spiral computed tomography (MSCT)-derived maximum tumor diameter and necrotic area ratio (NAR) for predicting very high-risk GISTs.
METHODS
We enrolled 158 patients with primary GIST treated at Binhai County People’s Hospital (January2025 to October 2025). The patients underwent preoperative plain abdominal MSCT and triple-phase enhanced scanning. Based on postoperative pathology, the patients were categorized as very high-risk or non-very high-risk. Univariate and multivariate logistic regression analyses identified independent predictors of very high-risk GISTs. The diagnostic efficacy of the combined predictive model was evaluated using receiver operating characteristic (ROC) curves.
RESULTS
Among 158 patients with primary GIST, 35 (22.2%) were classified as very high-risk. Multivariate logistic regression identified maximum tumor diameter and NAR as independent predictors of very high-risk GISTs (both P < 0.01). The combined predictive model demonstrated excellent diagnostic performance [area under the ROC curve (AUC) = 0.968], yielding a significantly higher AUC than that of either parameter alone.
CONCLUSION
MSCT-derived maximum tumor diameter and NAR are reliable independent predictors of very high-risk GISTs. Their combined predictive model facilitates accurate, non-invasive preoperative risk stratification, guiding individualized clinical decision-making.
Core Tip: Quantitative multi-slice spiral computed tomography imaging biomarkers may improve the preoperative assessment of gastrointestinal stromal tumor (GIST) aggressiveness. This study demonstrated that maximum tumor diameter combined with necrotic area ratio achieved high predictive performance for identifying very high-risk GISTs, providing practical support for individualized clinical management.
