经腹部超声预测胃间质瘤生物危险度的多因素logistic回归分析  

Multivariate logistic regression analysis of biorisk prediction of gastric gastrointestinal stromal tumor by transabdominal ultrasonography

作　　者：唐秀斌 郭晶晶[1] 钱清富 张秀娟[1] 陈志奎[1] 薛恩生[1] 林礼务[1] TANG Xiubin;GUO jingjing;QIAN Qingfu;ZHANG Xiujuan;CHEN Zhikui;XUE Ensheng;LIN Liwu(Department of Ultrasound,Fujian Medical University Union Hospital,Fujian Institute of Ultrasound Medicine,Fuzhou 350001,Fujian Province,China)

机构地区：[1]福建医科大学附属协和医院超声科,福建省超声医学研究所,福州350001

出　　处：《肿瘤影像学》2022年第6期607-611,共5页Oncoradiology

基　　金：福建省卫生教育联合攻关项目(2019-WJ-06)。

摘　　要：目的:探讨超声征象预测胃间质瘤生物危险度的应用价值。方法:回顾并分析经病理学检查证实的148例胃间质瘤的超声征象与临床资料,采用多因素logistic回归分析筛选出预测胃间质瘤生物危险度的独立影响因素,建立回归方程,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析logistic回归模型的预测价值。结果:超声征象中瘤体最大径、回声、囊性变、形态、边界、血流信号在低危组与中高危组胃间质瘤中比较差异均有统计学意义(P<0.001);瘤体生长部位、患者发病年龄、性别、有无症状,两组比较差异均无统计学意义(P>0.05)。多因素logistic回归分析结果显示瘤体的最大径、回声、形态均为鉴别不同危险度胃间质瘤的独立影响因素(OR值分别为1.34、3.81、2.64,P值分别为0.03、0.02、0.04)。构建的回归方程为logistic(P)=-3.03+0.30×最大径+1.34×回声+0.97×形态,以预测概率P=0.50作为阈值,其鉴别不同危险度胃间质瘤的灵敏度、特异度及准确度分别为78.2%、77.1%及77.7%,ROC曲线的曲线下面积为0.89。结论:以瘤体的最大径、回声、形态建立的logistic回归模型对预测胃间质瘤的生物危险度具有潜在临床应用价值。Objective:To explore the application value of ultrasound characteristics in predicting the biological risk of gastric gastrointestinal stromal tumors.Methods:The ultrasonic characteristics and clinical data of 148 cases of gastric gastrointestinal stromal tumors confirmed by pathology were retrospectively analyzed.Multivariate logistic regression analysis was used to screen out the independent influencing factors for the biological risk classification,and the regression equation was established.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of logistic regression model.Results:There were statistically significant differences in the maximum diameter,echo,cystic changes,morphology,boundary and blood flow signals between the low-risk and medium-high risk gastric gastrointestinal stromal tumor groups in ultrasonic signs(P<0.001).There were no significant differences in tumor growth site,age of onset,gender and symptom between the two groups(P>0.05).Multivariate logistic regression analysis showed that the maximum size,echo and morphology of the tumor were independent factors for the identification of gastric gastrointestinal stromal tumors with different risk levels(OR were 1.34,3.81,2.64,and P values were 0.03,0.02,0.04,respectively).The constructed logistic regression equation is logistic(P)=-3.03+0.30×maximum diameter+1.34×echo+0.97×morphology,with the prediction probability P=0.50 as the threshold.The sensitivity,specificity,accuracy and area under ROC curve were 78.21%,77.14%,77.70%and 0.89 respectively.Conclusion:Logistic regression model based on the maximum size,echo and morphology of tumor body has potential clinical value in predicting the biological risk of gastric gastrointestinal stromal tumor.

关 键 词：胃间质瘤 超声 生物危险度 LOGISTIC回归分析 

分 类 号：R735.2[医药卫生—肿瘤] R445.1[医药卫生—临床医学]