GIST患者病灶的128-MSCT影像特征与其病理危险度及免疫组化分型的相关性

Correlation between 128-MSCT imaging features and pathological risk and immunohistochemical classification in patients with GIST

目的:探讨胃肠道间质瘤(GIST)患者病灶的128-多层螺旋CT(128-MSCT)影像特征与其病理危险度及免疫组化分型的相关性。方法:选取2016年4月至2020年4月收治的经手术病理证实的120例GIST患者,所有患者行MSCT扫描,分析其影像特征,包括:大小、形态、肿块部位、肿块生长方式、CT值等。患者根据病理危险度分为极低危、低危、中危、高危组,根据免疫组化分型分为Ⅰ、Ⅱ、Ⅲ、Ⅳ型,比较各组间或者不同分型间影像特征差异,采用Pearson相关系数法分析影像特征与病理危险度及免疫组化分型的相互关系。结果:120例患者中极低危组21例、低危组24例、中危组39例、高危组36例,不同病理危险度患者间的肿瘤直径、肿瘤密度比较差异有统计学意义(P<0.05)。120例患者中Ⅰ型54例、Ⅱ型27例、Ⅲ型21例、Ⅳ型18例,不同免疫组化分型与肿瘤直径、肿瘤密度、CT强化程度差异有统计学意义(P<0.05)。Pearson相关系数法分析显示病理危险度与肿瘤直径、肿瘤密度具有显著正相关性,r值分别为0.639、0.685,P值均低于0.05,免疫组化分型与肿瘤直径、肿瘤密度以及CT强化程度具有相关性,r值分别为-0.732、0.715、-0.686,P值均低于0.05。结论:MSCT检查可有效评估GIST患者的肿瘤大小及密度,其影像特征对于免疫组化分型、病理危险度的区分具有重要的参考价值,有助于制定合理的治疗方案。

objective:To study the correlation between 128-MSCT imaging features and pathological risk and immunohistochemical classification in patients with GIST.Methods:120 GIST patients confirmed by surgery and pathology were selected from April 2016 to April 2020.All patients were scanned with MSCT,and their imaging features were analyzed,including size,shape,tumor location,tumor growth mode,CT value,etc.Patients were divided into extremely low-risk,low-risk,medium risk and high-risk groups according to the pathological risk degree.According to the immunohistochemical classification,patients were divided intoⅠ,Ⅱ,ⅢandⅣtypes.The differences of image characteristics between groups or different types were compared.The relationship between image characteristics,pathological risk degree and immunohistochemical classification was analyzed by Pearson correlation coefficient method.Results:Among 120 patients,21 cases in extremely low-risk group,24 cases in low risk group,39 cases in medium risk group and 36 cases in high risk group,and there were significant differences in tumor diameter and tumor density among patients with different pathological risk(P<0.05).Among 120 patients,54 cases in typeⅠ,27 cases in typeⅡ,21 cases in typeⅢand 18 cases in typeⅣ,and the differences of different immunohistochemical types and tumor diameter,tumor density and CT enhancement were statistically significant(P<0.05).Pearson correlation coefficient analysis showed that pathological risk had significant positive correlation with tumor diameter and tumor density,with r values of 0.639,0.685 and P were lower than 0.05,respectively.Immunohistochemical typing was correlated with tumor diameter,tumor density and CT enhancement,with r values of-0.732,0.715,-0.686 and P values were lower than 0.05,respectively.Conclusion:MSCT can effectively evaluate the tumor size and density of GIST patients,and its imaging features have important reference value for the classification of immunohistochemical classification and pathological risk,which is helpful to make a reasonable treatment plan.