胃肠道间质瘤患者多层螺旋CT影像特征与Ki-67表达水平及预后的关系研究  

Study on the Relationship between Multi-slice Spiral CT Image Features and Ki-67 Expression Level and Prognosis in Patients with Gastrointestinal Stromal Tumor

作　　者：宋芹霞[1] 王祥发 史恒峰[1] 李承慧 SONG Qin-xia;WANG Xiang-fa;SHI Heng-feng;LI Cheng-hui(Department of Medical Imaging,Anqing Municipal Hospital,Anqing 246000,Anhui Province,China;Department of Medical Oncology,Anqing Municipal Hospital,Anqing 246000,Anhui Province,China)

机构地区：[1]安庆市立医院医学影像科,安徽安庆246000 [2]安庆市立医院肿瘤内科,安徽安庆246000

出　　处：《中国CT和MRI杂志》2025年第2期164-167,共4页Chinese Journal of CT and MRI

基　　金：双能量CT多功能成像联合HP预测HER-2突变型胃癌治疗效果及预后(2023Z1004)。

摘　　要：目的分析胃肠道间质瘤(GIST)患者多层螺旋CT(MSCT)影像特征与Ki-67表达水平及预后的关系。方法选取2017年8月~2018年8月本院收治的100例GIST患者为研究对象,采用免疫组织化检测Ki-67表达水平,根据Ki-67增殖指数分为低表达组(Ki-67增殖指数≤5%)和高表达组(Ki-67增殖指数>5%),比较两组MSCT影像特征,采用Logistic回归分析影响Ki-67表达水平的因素;根据术后5年生存情况将患者分为生存组和死亡组,比较两组MSCT影像特征,采用COX比例风险回归分析影响预后的因素。结果Ki-67增殖指数高表达组肿瘤直径>5cm、肿瘤形态不规则、密度不均匀、肿瘤向外生长发生率明显高于低表达组(P<0.05);Logistic回归结果显示:肿瘤直径、肿瘤形态、密度、肿瘤生长方式均是Ki-67增殖指数表达的影响因素(P<0.05);死亡组肿瘤直径>5cm、肿瘤形态不规则、密度不均匀、肿瘤向外生长发生率明显高于生存组(P<0.05);COX回归结果显示:肿瘤直径、肿瘤形态、密度、肿瘤生长方式均是患者预后的影响因素(P<0.05)。结论肿瘤直径、肿瘤形态不规则、密度不均匀、肿瘤向外生长等MSCT影像特征与GIST患者Ki-67表达水平及预后均与有关,提示MSCT影像特征可用于评估GIST患者的Ki-67表达情况和预后。Objective To analyze the relationship between the multi-slice spiral CT(MSCT)imaging features and Ki-67 expression and prognosis in patients with gastrointestinal stromal tumor(GIST).Methods 100 patients with GIST admitted to our hospital from August 2017 to August 2018 were selected as the study subjects.Ki-67 expression level was detected by immunohistochemical method,and the patients were divided into low expression group(Ki-67 proliferation index≤5%)and high expression group(Ki-67 proliferation index>5%)according to Ki-67 proliferation index.MSCT imaging features of the two groups were compared.The factors affecting Ki-67 expression were analyzed by Logistic regression.Patients were divided into survival group and death group according to their 5-year survival.MSCT imaging features of the two groups were compared,and COX proportional risk regression was used to analyze the factors affecting prognosis.Results The incidence of tumor diameter>5cm,irregular shape,uneven density and outward growth in the high expression group of Ki-67 proliferation index was significantly higher than that in the low expression group(P<0.05).Logistic regression results showed that tumor diameter,tumor shape,tumor density and tumor growth pattern were all factors influencing the expression of Ki-67 proliferation index(P<0.05).The incidence of tumor diameter>5 cm,irregular shape,uneven density and outward growth in death group was significantly higher than that in survival group(P<0.05).COX regression results showed that tumor diameter,tumor shape,tumor density and tumor growth pattern were all factors influencing the prognosis of patients(P<0.05).Conclusion MSCT imaging features such as tumor diameter,irregular tumor shape,uneven tumor density and outward tumor growth are related to Ki-67 expression level and prognosis of GIST patients,suggesting that MSCT imaging features can be used to evaluate Ki-67 expression and prognosis of GIST patients.

关 键 词：胃肠道间质瘤 多层螺旋CT 影像特征 KI-67 预后 影响因素 

分 类 号：R730.7[医药卫生—肿瘤]