胃肠道间质瘤 MSCT征象与病理危险度分级的相关性

摘要

Objective:To investigate the MSCT features of gastrointestinal stromal tumors ( GISTs ) , and to predict high risks of GISTs by correlation and regression analysis.Methods:MSCT images of 110 patients with pathologically proved GISTs were reviewed retrospectively.CT features and risk grades were compared using Fisher's exact test,and Spearman correlation and multivariate logistic regression models.Results:Of the 110 patients, the most common location of GISTs was stomach (67.3%),followed by small intestine (27.3%),extragastrointestine (2.7%),esophagus(1.8%) and colon and rectum(0.9%).Lesion localization,size,shape,plan scan density,cystic change,necrosis,hemorrhage,calcification,gas,contour boundary,growth pattern,relation with the gastrointestinal tract, pattern of enhancement, tumor vessels, ascites and distant metastasis were significantly different among the low-moderate-high risk groups(P<0.05).Among them,size,tumor vessels,shape,pattern of enhancement,necrosis,plan scan density,contour boundary and growth pattern were moderately or highly relevant to risk grades ( r=0.818,0.698,0.673,0.648,0.624,0.589,0.544,0.498,P<0.05).Size and shape were statistically independent predictors for high risk GISTs in multivariate logistic regression(P<0.05).How-ever,ulceration,bowel obstruction,degree of enhancement and lymphadenopathy had no significant difference among the three groups. (P>0.05).Conclusion:MSCT features could reflect the risk grades of GISTs.Size and shape could be considered as predictors for high risk GISTs.%目的：探讨胃肠道间质瘤MSCT征象与病理危险度分级间的关系。方法：回顾性分析110例病理证实的胃肠道间质瘤MSCT图像资料，采用Fisher准确概率法，Spearman，Logistic统计方法分析CT征象与危险度的相关性。结果：110例病例中，胃部发病率最高（67．3％），而后依次是小肠（27．3％）、胃肠外（2．7％）、食管（1．8％）、结直肠（0．9％）。发病部位、大小、肿瘤形态、平扫密度、囊变、坏死、出血、钙化、气体、轮廓、生长方式、与胃肠道关系、强化方式、肿瘤血管、腹水、远处转移在危险度分级中差异有统计学意义（ P＜0．05），其中大小、肿瘤血管、形态、强化方式、坏死、平扫密度、轮廓、生长方式与危险度呈中－高度相关（r值分别为0．818，0．698，0．673，0．648，0．624，0．589，0．544，0．498，P值均小于0．05）。在多分类Logistic模型中，肿瘤大小及形态是预测高危胃肠道间质瘤的指标（ P＜0．05）。溃疡、肠梗阻、强化程度、淋巴结肿大征象在危险度分级中差异无统计学意义（ P＞0．05）。结论：MSCT征象可反映胃肠道间质瘤危险度，肿瘤大小及形态可作为高危险胃肠道间质瘤的预测指标。