胃肠道间质瘤CT影像特征与危险度分级及Ki-67指数相关性分析  

Analysis of correlation between CT imaging characteristics,risk classification and Ki-67 index of gastrointestinal stromal tumors

作　　者：张芷菡 印隆林 刘一铭[4] 孙菊 ZHANG Zhi-han;YIN Long-lin;LIU Yi-ming;SUN Ju(Department of Radiology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Radiology,Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital(Affiliated Hospital of University of Electronic Science and Technology of China),Chengdu 610072,China;Institute of Radiation Medicine,Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital(Affiliated Hospital of University of Electronic Science and Technology of China),Chengdu 610072,China;Department of Radiology,Wenjiang District People's Hospital,Chengdu 611130,China)

机构地区：[1]西南医科大学附属医院放射科,四川泸州646000 [2]四川省医学科学院·四川省人民医院(电子科技大学附属医院)放射科,四川成都610072 [3]四川省医学科学院·四川省人民医院(电子科技大学附属医院)放射医学研究所,四川成都610072 [4]成都市温江区人民医院放射科,四川成都611130

出　　处：《实用医院临床杂志》2024年第6期78-83,共6页Practical Journal of Clinical Medicine

基　　金：四川省科技厅重点研发项目(编号:23ZDYF1685,2021YFS0375);四川省干保局普及应用项目(编号:川干研2023-215)。

摘　　要：目的探讨胃肠道间质瘤(GIST)的临床、病理及CT影像特征与其病理危险度分级及Ki-67指数的相关性。方法回顾性纳入201例经手术病理证实的GIST患者的临床、病理及CT影像资料,比较不同危险度分级组间、Ki-67低表达组(Ki-67≤5%)与高表达组(Ki-67>5%)间临床、病理及CT征象的差异性,并分析其与GIST危险度分级及Ki-67指数的相关性。结果201例患者分为低风险组95例(47.26%)、中风险组52例(25.87%)、高风险组54例(26.87%);Ki-67低表达组161例(80.1%)、高表达组40例(19.9%)。不同危险度分级GIST患者的年龄、肿瘤部位、大小、形态、边界、生长方式、有无气体及强化方式比较,差异有统计学意义(P<0.05),其中肿瘤大小、形态及强化方式与危险度分级具有中-高度相关性(r=0.419~0.765,P<0.05),其余呈弱相关性。不同Ki-67指数GIST患者的肿瘤核分裂象、大小、形态、边界及强化方式比较,差异有统计学意义(P<0.05),其中肿瘤核分裂象与Ki-6指数具有中度相关性(r=0.508,P<0.05),其余呈弱相关性。结论不同危险度分级及Ki-67指数表达的GIST患者的临床病理资料及CT征象存在一定差异性,仔细分析肿瘤的CT影像特征及相关资料,可术前无创性评估肿瘤的恶性潜能并预测患者预后。Objective To explore the correlation between clinical,pathological and CT features of gastrointestinal stromal tumor(GIST)and its pathological risk grade and Ki-67 index.Methods Clinical,pathological and CT imaging data of 201 patients with surgically and pathologically confirmed GIST were retrospectively included.The differences in clinical,pathological and CT signs between different risk grading groups and the low Ki-67 expression group(Ki-67≤5%)and the high Ki-67 expression group(Ki-67>5%)were compared.The correlation between the GIST risk grade and Ki-67 index and the clinical,pathological and CT characteristics were analyzed.Results Among the patients,there were 95 in low-risk group(47.26%),52 in medium-risk group(25.87%)and 54 in high-risk group(26.87%).There were 161(80.1%)in low Ki-67 expression group and 40(19.9%)in high Ki-67expression group.There were statistically significant differences in age,tumor site,size,shape,boundary,growth pattern,presence or absence of gas and enhancement of GIST with different risk grades(P<0.05).The tumor size,shape and enhancement mode had a medium-high correlation with the risk grade(r=0.419~0.765,P<0.05).The rest showed a weak correlation.There were statistically significant differences in the tumor mitogram,size,shape,boundary,and enhancement pattern of GIST patients with different Ki-67 index(P<0.05).There had a medium correlation between tumor mitotic image and Ki-67 index(r=0.508,P<0.05).The rest showed a weak correlation.Conclusions There are some differences in clinicopathologic data and CT characterastics of GIST with different risk grades and Ki-67 index.Careful analysis of the CT image features and related data of tumors can noninvasively evaluate the malignant potential of tumors before surgery and predict the prognosis of patients.

关 键 词：CT影像特征 胃肠道间质瘤 危险度分级 KI-67指数 

分 类 号：R814.42[医药卫生—影像医学与核医学]