C0684 - Risk Factors for Malignancy in Patients With Gastric Wall Thickening

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

Danial Nadeem, MD

Medstar Washington Hospital Center
Danville, PA

Danial Nadeem, MD¹, Akram I. Ahmad, MBBS¹, Won k. Cho, MD²
¹Medstar Washington Hospital Center, Washington, DC; ²Inova Fairfax Hospital, Washington, DC

Introduction: Gastric wall thickening (GWT) can be due to an amalgam of reasons, including, but not limited to gastrointestinal (GI) malignancy, infection, ischemia or inflammation. Current data suggests that focal, irregular and asymmetrical thickening of the GI tract can indicate malignancy. The aim of our project was to identify predisposing risk factors in patients with GWT, predictive for GI malignancy.

Methods: Extensive electronic medical record review was performed to identify patients 18 years of age or older with computed tomography scan reports including the word, “thickening”. A follow up endoscopy report with biopsy results was necessary for inclusion. Data, including patient demographics such as age, gender, race, body mass index (BMI) and lab results were collected. Pathology reports of biopsy specimens were also reviewed and recorded. P-values were then calculated using Wilcoxon rank sum test for comparison of medians and chi-squared test for categorical values.

Results: 99 patients, 39 males and 60 females, with a history of GWT were identified and included in our study. 84 patients (85%) were African American (A.A.), 6 were Caucasian (6%) and 5 (5%) were Hispanic. 13 patients with GWT had pathology consistent with malignancy, of which, 8 had gastric adenocarcinoma, 3 had mesenchymal or stromal tumors, one had lymphoma and one had metastatic disease. Race was found to be the sole statistically significant risk factor associated with a higher risk of malignancy (p-value < .03). Of the 13 patients with malignancy, 9 were A.A. (69%) and 2 (15%) were of Hispanic origin. None of our Caucasian or Asian cohort had evidence of malignancy. Gender, BMI, and lab work including hemoglobin, white cell count, metabolic panel, liver enzymes, coagulation factors and thyroid function were not found to be statistically significant

Discussion: Currently, data regarding risk factors associated with GWT leading to malignancy is scarce. Our research highlights that African Americans made up the highest percentage of patients in both the malignancy and non-malignancy cohort. There was also a higher percentage of Hispanic patients in the malignancy group compared to the non-malignancy group. There were no Caucasian or Asian patients with evidence of malignancy in our study. Differences in BMI and blood work were not found to be statistically significant. Further research is necessary to determine other possible risk factors for malignancy which may exist but were not noted during the course of this study.

Patients without Malignancy (n=86)			Patients with Malignancy (n=13)
Sex	Number (n)	%	Sex	Number (n)	%	P-value
Male	32	37.21%	Male	7	53.85	.253
Female	54	62.79%	Female	6	46.15	.253

Race	Number (n)	%	Race	Number (n)	%	P-value
African American	75	87.21	African American	9	69.23	.03
White	6	6.98	White	0	0
Hispanic	3	3.49	Hispanic	2	15.38
Asian	1	1.16	Asian	0	0
Others	0	0	Others	1	7.69
Unknown	1	1.16	Unknown	1	7.69

BMI	Number (n)	%	BMI	Number (n)	%	P-value
Underweight	5	5.81	Underweight	2	15.38	.072
Normal	27	31.4	Normal	5	38.46
Overweight	21	24.4	Overweight	5	38.46
Obese	33	38.3	Obese	1	7.69

Table: Demographics of patients with GWT including sex, race and BMI.

Disclosures:

Danial Nadeem indicated no relevant financial relationships.

Akram Ahmad indicated no relevant financial relationships.

Won Cho indicated no relevant financial relationships.

Danial Nadeem, MD¹, Akram I. Ahmad, MBBS¹, Won k. Cho, MD². C0684 - Risk Factors for Malignancy in Patients With Gastric Wall Thickening, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.