不同侵袭危险性胃间质瘤的超声内镜图像特点

Endoscopic ultrasonographic features of gastric stromal tumors with different risk of invasion

目的探究不同侵袭危险性胃间质瘤(GSTs)的超声内镜图像特点。方法回顾性选取2015年1月至2020年10月惠州市中心人民医院收治的130例GSTs患者作为研究对象,依据肿瘤大小及核分裂象将患者分为极低危组(n=57)、低危组(n=42)、中危组(n=19)、高危组(n=12)。分析不同侵袭危险性GSTs患者超声内镜图像特点,探究GSTs的相关危险因素。结果超声内镜图像显示,130例GSTs患者中肿瘤形状规则者占92.31%(120/130),起源于胃固有肌层者占78.46%(102/130),病灶多呈低回声、均匀回声,边界清晰,少部分存在钙化、溃疡及囊性病变。随着侵袭危险性的增加,表面溃疡、钙化及囊性变比例明显升高,即高危组、中危组GSTs患者表面溃疡、钙化以及囊性变发生率显著高于低危组与极低危组,差异均有统计学意义(P<0.05);从回声均匀性情况看,极低危组回声均匀占比显著高于低危组、中危组与高危组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,表面溃疡、钙化、囊性变及回声均匀性与GSTs侵袭危险性密切相关(P<0.05)。结论不同侵袭危险性GSTs超声内镜图像具有一定的差异性,表面溃疡、钙化及囊性、回声均匀性是预测侵袭危险性的重要标志。

Objective To explore the endoscopic ultrasonographic features of gastric stromal tumors(GSTs)with different risk of invasion.Methods One hundred and thirty cases of GSTs patients were chosen between January 2015 and October 2020 in Huizhou Center of People's Hospital as the research object,on the basis of tumor size and fission like,they were divided into very low risk group(n=57),low risk group(n=49),moderate group(n=19)and high-risk(n=12)group,the different invasive endoscopic ultrasound image characteristics of patients at risk GSTs were analyzed to explore the related risk factors of GSTs.Results Endoscopic ultrasound images showed that 92.31%(120/130)of the 130 patients with GSTs had a regular tumor shape,and 78.46%(102/130)of the tumor originated in the gastric muscularis propria.The lesions were mostly hypoechoic and uniform echo.Clear,calcification,ulcers and cystic lesions are present in a small part.As the risk of invasion increased,the proportions of surface ulcers,calcification,and cystic changes increased significantly,that is,the incidence of surface ulcers,calcification,and cystic degeneration of GSTs in the high-risk group and the intermediate-risk group was significantly higher than that of the low-risk group and the very low-risk group,and the differences were statistically significant(P<0.05);from the perspective of echo uniformity,the average proportion of echo in the low-risk group was significantly higher than that in the low-risk group,intermediate-risk group and high-risk group,and the differences were statistically significant(P<0.05).Conclusion GSTS endoscopic ultrasound images of different invasion risk have certain differences,surface ulcer,calcification,cystic and echo uniformity are important markers to predict invasion risk.