原发性小肠间质瘤多层螺旋CT征象、危险度分级及Ki67表达与预后关系

Relationship between MSCT Features,Risk Grade,Ki67 Expression and Prognosis of Primary Small Intestinal Stromal Tumors

目的探讨原发性小肠间质瘤的多层螺旋CT征象、危险度分级、Ki67表达与预后关系,提高原发性小肠间质瘤的术前诊断率、危险度评估及预后评估。方法回顾性分析2014至2019年我院45例经病理证实的原发性小肠间质瘤的临床及影像资料,依据病理分级分为低危险组(17例)和高危险组(28例),分析两组间肿瘤形态、大小、生长方式间差异;对所有患者进行随访;将患者分为无复发组(37例)与复发或转移组(8例),分析两组间肿瘤大小、各期CT值、KI67间差异。结果低危险组和高危险组间,肿瘤发生部位、大小、囊实性、增强动脉期、静脉期及延迟期比较,差异有统计学意义(P<0.05)。无复发组与复发或转移组间,肿瘤大小和Ki-67表达差异具有统计学意义(P<0.05),肿瘤大小的截点为5.1cm,敏感度为64.86%,特异性为87.5%;Ki-67表达的截点分别为4%,敏感度为5.71%,特异性为87.5%。结论多层螺旋CT征象有利于诊断原发性小肠间质瘤及评估危险度分级,肿瘤大小及Ki-67表达对临床评估预后有一定价值。

Objective To investigate the relationship between multi-slice spiral CT signs,risk grade,Ki67 expression and prognosis of primary small intestinal stromal tumors,and to improve the preoperative diagnosis rate,risk assessment and prognosis assessment of primary small intestinal stromal tumors.Methods The clinical and imaging data of 45 cases of pathologically confirmed primary small intestinal stromal tumors in our hospital from 2014 to 2019 were retrospectively analyzed.According to the pathological grade,the patients were divided into low-risk group(17 cases)and high-risk group(28 cases).All patients were followed up.The patients were divided into non-recurrence group(n=37)and recurrence or metastasis group(n=8).The differences in tumor size,CT value of each stage and Ki67 between the two groups were analyzed.Results There were significant differences in tumor location,size,cyst-solid,enhanced arterial phase,venous phase and delayed phase between the low-risk group and the high-risk group(P<0.05).There were significant differences in tumor size and Ki-67 expression between the non-recurrence group and the recurrence or metastasis group(P<0.05).The cut-off point of tumor size was 5.1cm,the sensitivity was 64.86%,and the specificity was 87.5%.The cut-off point of Ki-67 expression was 4%,the sensitivity was 5.71%,and the specificity was 87.5%.Conclusion MSCT features are helpful for the diagnosis of primary small intestinal stromal tumors and the assessment of risk grade.Tumor size and Ki-67 expression have certain value for clinical assessment of prognosis.