MSCT评估胃肠道间质瘤转移风险  

MSCT evaluation on metastastic risk of gastrointestinal stromal tumors

作　　者：冯秋霞 孙娜娜[1] 刘畅[1] 张海龙[1] 徐迅[1] 孙书文 刘希胜[1] FENG Qiuxia;SUN;LNana IU Chang;ZHANG Hailong;XU Xun;SUN Shuwen;LIU Xisheng(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029

出　　处：《中国医学影像技术》2018年第12期1830-1833,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨MSCT评估胃肠道间质瘤(GIST)转移风险的价值。方法回顾性分析118例经病理诊断为GIST患者的临床及影像学资料,根据转移发生率将患者分为低转移风险组(转移风险<10%)和高转移风险组(转移风险≥10%)。比较2组影像学特征间的差异,采用多因素Logistic回归分析评价影像学特征与转移风险之间的关系。结果 118例GIST中,低转移风险组78例,高转移风险组40例。2组肿瘤位置、大小、形态、生长方式、坏死程度、有无溃疡、边界是否清晰、有无肿瘤血管影、强化程度及强化方式差异均有统计学意义(P均<0.05),而肿瘤有无出血、钙化的差异均无统计学意义(P均>0.05)。多因素分析显示肿瘤直径[95%CI(2.675,201.134),P=0.004]是预测GIST高转移风险的独立危险因素,AUC=0.76(P<0.001),阈值为4.45cm时其预测GIST高转移风险的敏感度、特异度分别为67.50%、75.60%。结论 MSCT可通过影像学特征反映GIST转移风险,为临床选择治疗方式提供参考。Objective To investigate the value of MSCT in assessment of the metastastic risk of gastrointestinal stromal tumors (GIST).Methods Clinical and imaging data of histopathologically proved GIST in 118patients were retrospectively analyzed.According to the incidence of metastasis,the patients were divided into low metastatic risk group (metastatic risk <10%)and high metastatic risk group (metastatic risk ≥10%).The imaging features were compared between the two groups,and the relationship of imaging features and metastatic risk was evaluated with multivariate Logistic regression analysis.Results Among the 118 patients,low metastatic risk group included 7.8 patients and high metastatic risk group included 40 patients.There were statistically significant differences of CT features in tumor location, size,shape,growth pattern,necrosis degree,with or without ulceration and clear boundary,tumor vessels,enhancement degree and pattern between the two groups (all P<0.05).There was no significant difference of bleeding nor calcification between the two groups (both P>0.05).Multivariate analysis showed that tumor diameter (95%CI [-2.675,201.134], P=0.004)was an independent risk factor for predicting the risk of high metastasis of GIST,and AUC was 0.76(P< 0.001).Taken tumor diameter =4.45cm as the threshold,the sensitivity and specificity of predicting GIST high metastasis risk was 67.50% and 75.60%,respectively.Conclusion MSCT features can predict the metastatic risk of GIST,therefore providing references for treatment choice.

关 键 词：胃肠道间质瘤 肿瘤转移 体层摄影术 X线计算机 

分 类 号：R735[医药卫生—肿瘤] R814.42[医药卫生—临床医学]