分析不同危险度胃间质瘤超声内镜特征及免疫组化结果的相关性  

Analyzing the correlation between endoscopic ultrasound features and immunohistochemical results of gastric stromal tumors with different risk levels

作　　者：王露露 师荣慧 董娜 冯洁[2] 黄晓俊[2] WANG Lu-lu;SHI Rong-hui;DONG Na;FENG Jie;HUANG Xiao-jun(The Second School of Clinical Medicine,Lanzhou University,Lanzhou City,Gansu Province,730000,China;Department of Gastroenterology,The Second Hospital of Lanzhou University,Lanzhou City,Gansu Province,730000,China)

机构地区：[1]兰州大学第二临床医学院,730000 [2]兰州大学第二医院消化内科,730000

出　　处：《现代消化及介入诊疗》2024年第3期281-286,291,共7页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：甘肃省青年科学基金(21R1RA155);兰州大学第二医院萃英科技创新计划(2020QN-12)。

摘　　要：目的探讨不同危险度胃间质瘤超声内镜特征及免疫组化结果的相关性,为临床诊断和治疗提供参考。方法回顾性收集2018年1月至2023年7月就诊于兰州大学第二医院并行手术治疗的胃间质瘤患者相关指标,分析不同危险度之间的差异性。结果胃间质瘤的平均发病年龄为(56.02±10.94)岁,首发症状为黑便对于胃间质瘤的不同分级有意义,不同危险度的患者所接受的治疗方式也有显著差异(P<0.05)。极低危、低危、中危、高危四组的部位、起源层次、边界、回声、有无囊性变、钙化或血流信号对危险度的分级无差异(P>0.05);肿瘤大小、生长方式、形状、内部回声均匀度、外观对于胃间质瘤术后危险分级评估有意义(P<0.05),多因素Logistic回归显示肿瘤大小是独立影响因素(P<0.05)。免疫组化结果示DOG-1、CD34、SMA、Desmin是否阳性对胃间质瘤术后危险度的分级无影响(P>0.05);而Vimentin的阳性表达、Ki-67指数及核分裂象与危险度显著相关(P<0.05)。结论胃间质瘤的不同侵袭度分级与病灶大小、形状、回声等有关系,超声内镜能较好地诊断胃间质瘤,结合免疫组化相关指标能更好地评估胃间质瘤患者的整体情况,为临床诊疗提供参考。Objective To explore the correlation between endoscopic ultrasound features and immunohistochemical results of gastric stromal tumors at different risk levels,and provide reference for clinical diagnosis and treatment.Methods Retrospective collection of relevant indicators of gastric stromal tumor patients who received concurrent surgical treatment at Lanzhou University Second Hospital from January 2018 to July 2023,and analysis of differences in risk levels.Results The average age of onset of gastric stromal tumors was(56.02±10.94)years old,and the initial symptom of black stool was significant for different grades of gastric SMTs.Patients with different risk levels also received significant differences in treatment methods(P<0.05).There was no difference in the classification of risk levels among the four groups of extremely low risk,low risk,medium risk,and high risk in terms of location,origin level,boundary,echo,presence or absence of cystic changes,calcification,or blood flow signals(P<0.05);Tumor size,growth pattern,shape,internal echo uniformity,and appearance are significant factors for postoperative risk grading of gastric stromal tumors(P<0.05).Multivariate logistic regression showed that tumor size is an independent influencing factor(P<0.05).The immunohistochemical results showed that the positivity of DOG-1,CD34,SMA,and Desmin had no effect on the postoperative risk grading of gastric SMTs(P<0.05);The positive expression of Vimentin,Ki-67 index,and mitosis were significantly correlated with risk(P<0.05).Conclusion The different invasion grades of gastric stromal tumors are related to the size,shape,and echo of the lesion.Endoscopic ultrasound can effectively diagnose gastric stromal tumors,and combining with immunohistochemical related indicators can better evaluate the overall condition of patients with gastric stromal tumors,providing reference for clinical diagnosis and treatment.

关 键 词：胃间质瘤 危险度 超声内镜特征 免疫组化 

分 类 号：R735.2[医药卫生—肿瘤] R573[医药卫生—临床医学]