影像学评估在预测韧带样纤维瘤术后复发中的价值

The value of imaging assessment in predicting postoperative recurrence of ligatnentoid fibroma

目的 通过对韧带样纤维瘤的临床、影像学表现及病理特征分析,应用COX风险比例回归模型,判断主要影像学特征对其术后是否复发及复发时间的影响.方法 回顾性分析经病理证实的54例韧带样纤维瘤患者的临床资料(性别、年龄、复发时间),影像学资料(肿瘤的部位、最大径、边界、CT强化比、MR强化比、T_(2)信号比),病理资料(Ki-67、镜下切缘).采用Kaplan-Meier法对上述指标进行单因素分析,再采用Cox风险比例模型,对肿瘤是否复发及复发时间与上述因子间是否存在相关性进行分析,并计算各因子的风险比.结果 54例中,女38例,男16例;年龄8~70(33.92±13.58)岁;总体1年、2年复发率分别为26%、45%,中位数复发年龄30岁.单因素分析结果显示:年龄、CT强化比、Ki-67、T_(2)信号比在复发及非复发者间差异有统计学意义;多因素分析显示:性别、肿瘤最大径、MR信号比、T_(2)信号比、Ki-67是肿瘤复发时间的独立危险因素(HR 0.425、1.100、1.515、1.304、1.084,P<0.05).结论 韧带样纤维瘤的影像学特征可以对术后复发做出客观判断.当患者为男性,肿瘤最大径越大,Ki-67数值高,MR信号比、T_(2)信号比高时,韧带样纤维瘤的术后更容易复发.

Objective To determine the efect of the main imaging features on whether it recurs after surgery and the recurrence time by analyzing the clinical,imaging and pathological features of desmoid fibroma,and using Cox proportional regression model.Methods The clinical data(gender,age,recurrence time),imaging data(tumor location,maximum diameter,boundary,CT enhancement ratio,MR enhancement ratio,T_(2) signal ratio)and pathological data(Ki-67,microscopic margin)of 54 patients with desmoid fibroma confirmed by pathology were retrospectively analyzed.Kaplan-Meier method was used for univariate analysis of the above indicators.Cox risk proportional model was used to analyze the correlation between tumor recurrence and recurrence time and the above factors,and the risk ratio of each factor was calculated.Results There were 38 females and 16 males of 54 cases.The average age was 33.92 years old±58 years old(8-70 years old),the overall 1-year and 2-year recurrence rates were 26%and 45%,respectively.Univariate analysis showed that there were significant differences in age,CT enhancement ratio,Ki-67 and T_(2) signal ratio between recurrent and non-recurrent patients,mulivariate analysis showed that gender,maximum diameter of tumor,MR signal ratio,T_(2) signal ratio and Ki-67 were independent risk factors of tumor recurrence,and the risk ratios were 0.425,1.100,1.515,1.304 and 1.084,respectively.Conclusion The imaging features of desmoid fibroma can make an objective judgment of postoperative recurrence.When the patient is male,the larger the maximum diameter of the tumor,the higher the Ki--67 value,and the higher the MR signal ratio and T_(2) signal ratio,the desmoid fibroma is more likely to relapse.