术前应用Philips CT成像特征预测胃肠道间质瘤高ki-67增殖指数的研究  

Application Value of Preoperative CT Features in Predicting High Ki-67 Proliferation Index of Gastrointestinal Stromal Tumors

作　　者：贾浩 范志刚 朱彬 崔创撑 JIA Hao;FAN Zhi-gang;ZHU Bin;CUI Chuang-cheng(Department of Imaging,3201 Hospital,Hanzhong 723000,Shaanxi Province,China;Department of Medical oncology,3201 Hospital,Hanzhong 723000,Shaanxi Province,China;Department of Radiology,Xi'an Ninth Hospital,Xi'an 710051,Shaanxi Province,China)

机构地区：[1]三二〇一医院影像科,陕西汉中723000 [2]三二〇一医院肿瘤内科,陕西汉中723000 [3]西安市第九医院放射医学科,陕西西安710051

出　　处：《中国CT和MRI杂志》2024年第1期130-132,共3页Chinese Journal of CT and MRI

基　　金：陕西省重点研发计划项目(2021SF-044)。

摘　　要：目的探讨术前Philips CT成像特征在预测胃肠道间质瘤(GIST)高Ki-67增殖指数中的应用价值。方法纳入2019年1月至2022年12月经本院收治GIST患者112例,采集术后病灶组织行免疫组化法测定Ki-67增殖指数的表达,按Ki-67增殖指数表达水平分为高Ki-67组及低Ki-67组,收集患者术前CT平扫及3期动态增强检查特征,行单因素及Logistic回归模型多因素明确影响GIST患者高Ki-67增殖指数独立性危险术前CT特征,且经受试者工作曲线(ROC)评估单一及联合术前CT特征预测GIST患者高Ki-67增殖指数诊断价值。结果除性别、年龄、肿瘤位置、肿瘤轮廓、生长方式、钙化、病灶表面溃疡、转移外,两组肿瘤大小、肿瘤边界、囊变或坏死、肿瘤增粗血管、强化方式及强化程度比较,差异有统计学意义(P<0.05);经Logistic回归模型多因素分析结果显示:影响GIST患者高Ki-67增殖指数独立性危险术前CT特征包括肿瘤大小(>5cm)、肿瘤边界(不清晰)及强化程度(轻度);经ROC结果显示:联合模型预测GIST患者高Ki-67增殖指数诊断价值最高,AUC值为0.874,灵敏度、特异度依次为85.00%、79.17%。结论术前CT特征中肿瘤大小(>5cm)、肿瘤边界(不清晰)及强化程度(轻度)与GIST患者Ki-67增殖指数高表达有密切关联,通过构建联合模型有助于早期识别Ki-67增殖指数高表达GIST患者,可为后续临床治疗方案制定提供关键信息。Objective To investigate the application value of preoperative Philips CT features in predicting high Ki67 proliferation index of gastrointestinal stromal tumor(GIST).Methods 112 GIST patients admitted to our hospital from January 2019 to December 2022 were included.The lesion tissues were collected after surgery for immunohistochemical assay to determine the expression of Ki-67 proliferating index.The patients were divided into high Ki-67 group and low Ki-67 group according to the expression level of Ki-67 proliferating index.Single factor and Logistic regression model were used to determine the independent risk of preoperative CT features affecting high Ki-67 proliferation index in GIST patients,and the diagnostic value of single and combined preoperative CT features in predicting high Ki-67 proliferation index in GIST patients was evaluated by receiver operating curve(ROC).Results In addition to gender,age,tumor location,tumor profile,growth pattern,calcification,lesion surface ulcer and metastasis,there were statistically significant differences in tumor size,tumor boundary,cystic degeneration or necrosis,tumor thickened vessels,enhancement pattern and enhancement degree between the two groups(P<0.05).Multivariate analysis of Logistic regression model showed that preoperative CT features affecting the independent risk of high Ki-67 proliferation index in GIST patients included tumor size(>5cm),tumor boundary(unclear)and degree of enhancement(mild).The ROC results showed that the combined model had the highest diagnostic value in predicting the high Ki-67 proliferation index in GIST patients,and the AUC value was 0.874.The sensitivity and specificity were 85.00%and 79.17%.Conclusion The preoperative CT features of tumor size(>5cm),tumor boundary(unclear)and enhancement degree(mild)are closely related to the high expression of Ki-67 proliferation index in GIST patients.The establishment of a combined model is helpful for early identification of GIST patients with high expression of Ki-67 proliferation index,whi

关 键 词：胃肠道间质瘤 CT特征 KI-67 

分 类 号：R735.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]