增强CT定量参数诊断胃肠道间质瘤危险度的价值及与预后不良的关系

Value of Enhanced CT Quantitative Parameters in the Diagnosis of Gastro⁃intestinal Stromal Tumors and Its Relationship with Poor Prognosis

目的 研究增强CT定量参数诊断胃肠道间质瘤(gastrointestinal stromal tumor, GIST)危险度的价值及与预后不良的关系。方法 选取2020年3月-2022年3月收治的GIST 120例,根据术后危险度分级分为非高危组68例和高危组52例,比较2组术前增强CT定量参数,分析增强CT定量参数与GIST术后危险度的相关性,通过受试者工作特征曲线分析增强CT定量参数诊断GIST术后危险度的价值;并比较术后1年不同预后患者术前临床资料、增强CT定量参数,采用多因素Logistic回归分析GIST预后不良的影响因素。结果 高危组增强起始时间、达峰时间短于非高危组,增强强度值、强度半降时间高于或长于非高危组(P<0.01)。增强起始时间、达峰时间与GIST术后危险度呈负相关(r=-0.426、-0.470,P<0.01),增强强度值、强度半降时间与GIST术后危险度呈正相关(r=0.518、0.635,P<0.01)。增强起始时间、增强强度值、达峰时间、强度半降时间联合诊断GIST患者术后危险度为高危的曲线下面积大于单独参数诊断(P<0.05)。肿瘤直径、增强起始时间、增强强度值、达峰时间、强度半降时间是GIST患者术后预后不良的影响因素(P<0.01)。结论 GIST患者增强CT定量参数与术后危险度、预后密切相关,各定量参数诊断GIST患者术后危险度具有一定价值,且对患者预后评估具有一定指导意义。

Objective To investigate the value of enhanced CT quantitative parameters in the diagnosis of gastrointes-tinal stromal tumor(GIST)and its relationship with poor prognosis.Methods In total,120 patients with GIST admitted from March 2020 to March 2022 were selected and divided into non-high risk group(n=68)and high risk group(n=68)accord-ing to postoperative risk grade.Enhanced CT quantitative parameters before surgery were compared between the two groups,and the correlation between enhanced CT quantitative parameters and postoperative risk of GIST was analyzed.The value of enhanced CT quantitative parameters in the diagnosis of postoperative risk of GIST was analyzed by receiver operating charac-teristic(ROC)curve,and preoperative clinical data and enhanced CT quantitative parameters of patients with different prog-nosis at one year after surgery were compared.Multivariate logistic regression analysis was used to analyze the influencing fac-tors of poor prognosis of GIST.Results The onset time and peak time of enhancement in high-risk group were shorter than those in non-high-risk group,while the intensity value of enhancement and half-decline time of intensity were higher or longer than those in non-high-risk group(P<001).The onset time and peak time of enhancement were negatively correlated with the postoperative risk of GIST(r=-0.426,-0.470,P<001),and the value of intensity enhancement and half-decline time were positively correlated with the postoperative risk of GIST(r=0.518,0.635,P<001).The area under the ROC curve(AUC)of the combined diagnosis of GIST patients with high postoperative risk was higher than that of single diagnosis(P<005).Tumor diameter,onset time of enhancement,intensity value of enhancement,peak time and half-decline time of intensi-ty were the factors influencing the prognosis of GIST patients(P<001).Conclusion Quantitative parameters of enhanced CT are closely related to postoperative risk and prognosis of GIST patients.Each quantitative parameter has certain value in the diag-nosis of postoperative risk of GIST patients and has certain guiding significance in the prognosis assessment of patients.