摘要
目的探讨多层螺旋CT对2~5cm胃间质瘤(GST)危险度分级的评估价值。方法选取165例经手术病理证实的2~5cm GST患者的临床、病理及影像学资料,根据病理结果分为肿瘤倾向良性生物学行为组(116例)和倾向恶性生物学行为组(49例),分析两组患者临床、CT特征的差异,运用多因素logistic回归分析及受试者工作特征曲线(ROC)分析独立影响因素对肿瘤危险度分级的诊断效能。结果GST的最大径、最小径、生长方式、形态、溃疡、囊变或坏死、肿瘤血管、肿瘤周围淋巴结、强化方式、强化程度等方面在危险度分级中差异均有统计学意义(P<0.05),其中肿瘤最大径、最小径、肿瘤血管与病理危险度分级呈中度正相关,肿瘤最大径的曲线下面积(AUC)最大,为0.894,特异度、准确度最高,分别为87.8%、87.3%。经Logistic回归分析,GST最大径线(OR=7.560,P<0.001)、生长方式(OR=2.747,P=0.002)、肿瘤血管(OR=5.817,P=0.001)为鉴别GST不同危险度分级的独立影响因素。将肿瘤最大径、生长方式、肿瘤血管联合,AUC为0.936,诊断效能均高于单一方法(Z=2.016~5.770,P=0.001~0.044);敏感度为83.3%,特异度为91.8%,准确度为89.6%,均高于单一方法。结论多层螺旋CT对2~5cm GST危险度的分级有重要诊断价值,联合肿瘤最大径、生长方式、肿瘤血管可以更好的评估肿瘤危险度分级,对患者术前评估及治疗方式的选择有重要意义。
Objective To explore the value of multi-slice spiral CT in evaluating the malignant risks of 2~5cm gastric stromal tumors.Methods The clinical,pathological and imaging data of 165 patients with 2~5cm gastric stromal tumor confirmed by operation and pathology were selected.According to the pathological results,the patients were divided into benign biological behavior group and malignant biological behavior group.The differences of clinical and CT features between the two groups were analyzed.Multivariate logistic regression analysis and receiver operating characteristic curve were used to analyze the diagnostic efficacy of independent influencing factors on tumor risk grade.Results There were statistically significant differences in the risk grades of gastric stromal tumors in terms of maximum diameter,minimum diameter,growth pattern,morphology,ulcer,cystic degeneration or necrosis,tumor blood vessels,peri-tumor lymph nodes,enhancement mode,and enhancement degree(P<0.05).The maximum diameter,minimum diameter and tumor vessels were moderately positively correlated with the pathological risk grade,and the AUC of the maximum diameter of the tumor was the largest(0.894).The specificity and accuracy were the highest,which were 87.8%and 87.3%,respectively.Logistic regression analysis showed that the maximum diameter of gastric stromal tumor(OR=7.560,P<0.001),growth pattern(OR=2.747,P=0.002)and tumor vessel(OR=5.817,P=0.001)were independent influencing factors to distinguish different risk grades of GST.When the maximum diameter of the tumor,the growth mode and the combination of tumor vessels,the AUC was 0.936,the diagnostic efficiency was higher than that of the single model(Z=2.016~5.770,P=0.001~0.044);the sensitivity was 83.3%,the specificity was 91.8%,and the accuracy was 89.6%,all of which were higher than the single model.Conclusion Multi-slice spiral CT has important diagnostic value in the malignancy risk staging of 2-5cm gastric stromal tumors.Combined with tumor maximum diameter,growth pattern and tumor vessels,the malignant risks can be better evaluated,which is of great significance for preoperative evaluation and choice of treatment.
作者
徐景景
于昊
朱来敏
赵鲁平
王芳芳
孙占国
陈月芹
XU Jingjing;YU Hao;ZHU Laimin;ZHAO Luping;WANG Fangfang;SUN Zhanguo;CHEN Yueqin(Department of Imaging,Affiliated Hospital of Jining Medical University,Jining 270029,China)
出处
《医学影像学杂志》
2024年第10期79-83,104,共6页
Journal of Medical Imaging
基金
国家自然科学基金项目(编号:82001805)
山东省医药卫生科技发展计划项目(编号:202109010447)
山东省济宁市重点研发计划项目(编号:2022YXNS061)。
关键词
胃间质瘤
体层摄影技术
X线计算机
危险度分级
Gastric stromal tumors
Tomography,X-ray computed
Malignancy risk staging
