胃肠道间质瘤的MSCT征象与临床病理的对照研究

A comparative study of multi-slice spiral CT features and clinicopathology of Gastrointestinal stromal tumors

目的探讨胃肠道间质瘤(GIST)的CT征象与病理及免疫组化指标的相关性。方法回顾性分析215例胃肠道间质瘤患者的CT征象及临床病理资料,观察CT影像学征象,记录GIST患者的病理资料及免疫组化指标如核分裂象(/50HPF)、Ki-67增值指数、CD117、DOG-1、CD34等。结果胃肠道间质瘤的危险度分级与患者的性别、肿瘤大小、发病部位、生长方式、形态、轮廓、肿瘤成分、强化方式、肿瘤有无血管、有无周围浸润、有无溃疡、瘤内有无气体、有无钙化、有无坏死、延迟期CT值、Ki-67增值指数、核分裂象(/50HPF)、CD34等存在明显差异,差异有统计学意义(P﹤0.05)。胃肠道间质瘤的危险度分级与患者的年龄、肿瘤强化程度、平扫CT值、动脉期CT值、静脉期CT值及免疫组化指标CD117、DOG-1的差异无统计学意义(P﹥0.05)。结论胃肠道间质瘤CT征象与其病理危险度分级具有密切的相关性,根据其CT征象对判定肿瘤的恶性程度及指导临床治疗具有重要的意义。

Objective To investigate the correlation between CT features and pathological and immunohistochemical indexes of gastrointestinal stromal tumor(GIST).Methods The CT signs and clinicopathological data of 215 patients with gastrointestinal stromal tumors were analyzed retrospectively.The imaging signs of CT were observed.The pathological data and immunohistochemical indexes of GIST patients were recorded,such as mitosis(/50HPF),Ki-67 increment index,CD117,DOG-1,CD34 and so on.Results The risk grade of gastrointestinal stromal tumors was significantly different from the patients'gender,tumor size,location,growth mode,shape,contour,tumor composition,enhancement mode,tumor with or without blood vessels,surrounding infiltration,ulcer,gas in tumor,calcification,necrosis,delayed CT value,Ki-67 increment index,mitosis(/50HPF),CD34 and so on.The difference was statistically significant(P﹤0.05).There was no significant difference between the risk grade of gastrointestinal stromal tumor and the patient's age,tumor enhancement degree,plain scan CT value,arterial phase CT value,venous phase CT value and immunohistochemical index CD117,DOG-1(P﹥0.05).Conclusion There is a close correlation between CT signs and pathological risk classification of gastrointestinal stromal tumors.According to their CT signs,it is of great significance to determine the malignant degree of tumors and guide clinical treatment.