胃肠间质瘤根治术后5年的预后因素  

Prognostic factors for gastrointestinal stromal tumors after radical surgery for 5 years

作　　者：何昌银 李传明 刘芸 HE Changyin;LI Chuanming;LIU Yun(Department of Imaging,Chongqing University Affiliated Central Hospital(The Fourth People's Hospital of Chongqing),Chongqing 400014,China)

机构地区：[1]重庆大学附属中心医院(重庆市第四人民医院)影像科,重庆400014

出　　处：《分子影像学杂志》2024年第7期750-756,共7页Journal of Molecular Imaging

基　　金：重庆市自然科学基金(cstc2020jcyjmsxmX0044)。

摘　　要：目的 分析胃肠间质瘤根治术后5年的预后因素,并建立生存预测模型以指导临床实践。方法 回顾性分析2010年1月5日~2018年6月20日本院行根治术治疗的297例胃肠间质瘤患者的临床病理及CT资料,以5年为观察截止点,将患者分为无复发生存组(n=232)和死亡(或复发转移)组(n=65),联合有统计学意义的临床病理及CT特征,建立Logistic回归模型,并评价模型效能。结果 临床病理特征与患者5年预后的关系:未辅助伊马替尼治疗、核分裂计数较高、高Ki-67指数的患者预后不佳的几率大,差异有统计学意义(P<0.05);而性别、年龄、消化道出血的差异无统计学意义(P>0.05)。CT特征与5年预后的关系:两组患者部位、大小、破裂、是否有粗大的供血动脉或引流静脉等的差异有统计学意义(P<0.05);而生长方式、溃疡、钙化、上覆黏膜的一过性强化等的差异无统计学意义(P>0.05);联合临床病理及CT特征的Logistic回归模型显示:部位、形态、大小、肿瘤破裂、肿瘤囊腔与肠管相通、核分裂像是5年预后的独立预测因素五,AUC为0.916,敏感度0.877,特异度0.802,正确率0.818。结论本研究建立了影响胃肠间质瘤根治术后5年预后的预测模型,该模型的预测性能好,为临床预后判断和评估提供了重要的依据。Objective To analyze the prognostic factors of gastrointestinal stromal tumors after radical surgery for 5 years and establish a survival prediction model to guide clinical practice.Methods A retrospective analysis was conducted on the clinical,pathological,and CT data of 297 patients with gastrointestinal stromal tumors who underwent radical surgery at our Hospital from January 5,2010 to June 20,2018.With a 5-year observation cut-off point,they were divided into non recurrence survival group(n=232)and death or recurrence metastasis group(n=65).A Logistic regression model was established by combining statistically significant clinical,pathological,and CT features,and the model efficacy was evaluated.Results The relationship between clinical pathological characteristics and 5-year prognosis of patients:Patients without adjuvant imatinib treatment,with high mitotic count,and high Ki-67 index have a higher probability of poor prognosis within 5 years,and the difference was statistically significant(P<0.05);However,gender,age,and gastrointestinal bleeding had no statistically significant difference in 5-year prognosis(P>0.05).The relationship between CT features and 5-year prognosis:There were statistically significant differences between the two groups in terms of location,shape,size,cystic change or necrosis,rupture,bleeding,tumor with cystic lumen communicating with the intestinal canal,is there a large blood supply artery or drainage vein,venous phase and delayed phase enhancement methods(P<0.05);However,there was no statistically significant difference in growth mode,ulcer,calcification and transient enhancement of the overlying mucosal line(P>0.05);Logistic regression combining clinical pathology and CT features:Tumor location,morphology,size,tumor rupture,tumor sac to intestinal communication,and mitotic imaging were independent predictors of 5-year prognosis.The AUC was 0.916,sensitivity was 0.877,specificity was 0.802,and accuracy was 0.818,all of which were higher than the subjective predictions of two radi

关 键 词：胃肠间质瘤 无复发生存 预测模型 

分 类 号：R735[医药卫生—肿瘤]