胃肠道间质瘤CT影像特征对照病理危险度评估的相关性研究  

Correlative Study of CT Imaging Features and Clinicopathological Risk Grades of Gastrointestinal Stromal Tumor

作　　者：苏海霞[1] 潘海虹[2] 张蕾[2] 

机构地区：[1]同济大学医学院临床三系 [2]同济大学附属东方医院影像科

出　　处：《中国医学计算机成像杂志》2014年第6期511-516,共6页Chinese Computed Medical Imaging

基　　金：上海浦东新区科技发展创新资金(PKJ2011-Y17);上海浦东新区"优秀学科带头人"计划(PWRd2012-10)~~

摘　　要：目的:术前不同CT影像特征的胃肠道间质瘤(GIST)的术后病理危险度分级之间存在显著差异,但其相关程度尚待建立。本研究旨在探讨该相关性,评价不同的CT特征对GIST危险度的判断价值。方法:回顾性分析经术后病理及免疫组化证实的GIST41例,采用皮尔逊相关系数法,确定CT特征与病理危险度分级之间的相关系数。结果:CT预评估为恶性倾向的肿块与评估为良性倾向的肿块相比,其侵袭性表现为中度危险及高度危险的比例显著增大(P<0.0001)。CT显示的肿瘤密度、大小、形态、边界、生长方式与病理危险度呈显著及高度相关(相关系数r值分别为0.777、0.769、0.637、0.573、0.493),但发生部位和强化程度与病理危险度呈弱相关(r=0.147和-0.205)。结论:CT影像特征可以反映GIST的病理危险度,CT特征在反应不同危险度GIST的相关程度存在差异性,其判断价值大小依次为:肿瘤密度﹥大小﹥形态﹥边界﹥生长方式﹥发生部位。CT术前预评估GIST的侵袭性,有助于制定合理的治疗方案。Purpose： To study the consensus of pre-surgery computed tomography （CT） scan and post- surgery pathological risk grades of gastrointestinal stromal tumors （GIST）. Methods： Retrospective analysis was performed to evaluate the CT features of 41 patients with pathologically and immunohistochemically confirmed GIST. The CT features of tumor density, size, boundary, location, growth pattern, enhanced pattern were analyzed. Pearson correlation coefficient was determined between CT features and pathological risk grades. Results： CT predicted malignancy was highly correlated with pathological risk grades （r=0.771）. Compared to CT-predicted benign GIST, CT-predicted malignant GIST had a significantly higher possibility to be diagnosed as intermediate and high risk GIST by pathologically risk grades （p〈0.0001）. CT-assessed tumor density, size and intra-tumor necrosis were highly positively correlated with CT-predicted malignancy. Their correlation coefficients were 0.777 and 0.769, respectively. The correlations of CT-predicted malignancy with other CT criteria were： significantly correlated with tumor shape and contour （r=0.637 and 0.573, respectively）, moderately correlated with growth pattern （r=0.493）, poorly correlated with tumor location （r=0.147）, and poorly negatively correlated with enhancement （r=-0.205）. Conclusion： CT imaging characteristics can be used to predict GIST malignancy. Their relevance from high to low are as follows： tumor density 〉 size 〉 shape 〉 boundary 〉 growth pattern 〉 location. Analysis of CT features is valuable for pre-surgery evaluation of GIST.

关 键 词：胃肠道间质瘤 病理学 危险度分级 体层摄影术 X线计算机 

分 类 号：R735[医药卫生—肿瘤]