多层螺旋CT在胃神经内分泌癌与胃间质瘤中的鉴别诊断价值  

Value of multislice spiral CT scanning in differential diagnosis of gastric neuroendocrine carcinoma and gastric stromal tumor

作　　者：黄佩云 何晓璞 刘高双 孙梦雪 吴胜男 华杰[2] HUANG Pei-Yun;HE Xiao-Pu;LIU Gao-Shuang;SUN Meng-Xue;WU Sheng-Nan;HUA Jie(Department of Geriatric Gastroenterology,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Gastroenterology,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老年消化内科,南京210029 [2]南京医科大学第一附属医院消化内科,南京210029

出　　处：《中华老年多器官疾病杂志》2020年第8期576-580,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：东南大学-南京医科大学合作研究项目(2242018K3DN27)。

摘　　要：目的探讨胃神经内分泌癌(G-NEC)与胃间质瘤(GST)在多层螺旋CT下的影像特征。方法回顾性分析2010年5月至2019年7月在南京医科大学第一附属医院住院治疗的G-NEC和GST患者的临床资料。依据病理结果分为2组:G-NEC组(n=21)和GST组(n=34)。对比2组的临床资料及CT特征,包括肿瘤位置、肿瘤最长径、肿瘤生长方式、肿瘤数量、肿瘤形态等。采用SPSS 22.0软件进行统计分析。2组间比较采用t检验或χ^2检验。采用logistic回归分析筛选GST和G-NEC的独立鉴别因子。结果在一般资料中,G-NEC在男性多见,而GST在女性中多见,性别可以作为GST和G-NEC的独立鉴别因子(OR=0.02,P=0.015)。G-NEC组(60.9±10.7)岁和GST组(60.5±13.3)岁在年龄上差异并无统计学意义(P>0.05)。通过对两组患者的CT表现分析,两组患者在肿瘤位置(P<0.001)、淋巴结转移(P=0.012)、肝转移(P=0.006)、肿瘤生长方式(P=0.014)、肿瘤形态(P<0.001)、黏膜完整性(P=0.001)和肿瘤边界(P<0.001)是否清晰上的差异均有统计学意义,随后对以上特征进行多因素分析,性别(OR=0.02,P=0.015)和肿瘤形态(OR=18.61,P=0.022)可作为GST和G-NEC的独立鉴别因子,其中肿瘤形态是GST和G-NEC最显著的鉴别因子。结论CT对于G-NEC和GST的鉴别诊断有一定的临床意义。Objective To investigate the imaging features of gastric neuroendocrine carcinoma(G-NEC)and gastric stromal tumor(GST)under multi-slice spiral CT scan.Methods A retrospective study was carried out on the pathologically identified G-NEC(n=21)and GST patients(n=34)who were hospitalized in our hospital from May 2010 to July 2019.The clinical data and CT features(including tumor location,tumor longest diameter,tumor growth pattern,tumor number and tumor morphology)were compared between the two groups.SPSS statistics 22.0 was used to perform the statistical analysis.Student′s t test or Chi-square test was employed for comparison between groups,and logistic regression analysis was applied to screen the independent differentiators between GST and G-NEC.Results In general data,G-NEC was more common in men,while GST was more common in women.Gender can be used as an independent distinguishing factor between GST and G-NEC(OR=0.02,P=0.015).G-NEC group(60.9±10.7 years old)and GST group(60.5±13.3 years old)had no statistical significance in age(P>0.05).Through the analysis of the CT findings of the two groups of patients,the location of the tumor(P<0.001),lymph node metastasis(P=0.012),liver metastasis(P=0.006),tumor growth pattern(P=0.014),tumor morphology(P<0.001),mucosal integrity(P=0.001),and tumor boundary(P<0.001)were all significant differences in clarity.Subsequently,a multivariate analysis of the above characteristics was performed.Gender(OR=0.02,P=0.015)and tumor morphology(OR=18.61,P=0.022)can be used as independent distinguishing factors between GST and G-NEC,and tumor morphology was the most significant distinguishing factor between GST and G-NEC.Conclusion CT scan is of certain clinical significance for differential diagnosis between G-NEC and GST.

关 键 词：胃神经内分泌癌 胃间质瘤 计算机断层扫描 鉴别诊断 

分 类 号：R730.44[医药卫生—肿瘤] R735[医药卫生—临床医学]