摘要
目的探讨基于术前增强CT的3D定量形状特征对原发性胃肠道间质瘤(gastrointestinal stromal tumors,GIST)患者行完全切除术后无病生存期(disease-free survival,DFS)的预测价值。方法回顾性选择2010年1月至2016年12月在复旦大学附属中山医院接受肿瘤完全切除术并经病理诊断为原发性胃部GIST的154例患者。评估腹盆腔CT传统影像学特征和肿瘤3D定量形状特征,采用单因素及多因素Cox回归分析DFS的影响因素。提取截断值并采用Kaplan-Meier曲线进行生存分析。结果最大三维直径(HR=1.829,95%CI 1.389~2.408,P<0.001)和球面歧化(HR=2.153,95%CI 1.474~3.146,P<0.001)是原发性胃部GIST术后DFS的独立风险因素。Kaplan-Meier曲线显示,最大三维直径>90.5 mm或球面歧化>1.5的原发性胃部GIST患者接受完全切除术后的DFS更短(P<0.001)。结论基于术前增强CT的3D定量形状特征参数(最大三维直径和球面歧化)对原发性胃部GIST患者术后DFS具有临床辅助诊断价值。
Objective To explore the predictive value of 3D quantitative shape features based on enhanced CT for disease-free survival(DFS)of primary gastric gastrointestinal stromal tumors(GIST)patients receiving curative resection.Methods From January 2010 to December 2016,a total of 154 patients with primary gastric GIST who received curative resection in Zhongshan Hospital,Fudan University were retrospectively collected.The conventional CT imaging features and 3D quantitative shape features of tumors were evaluated,and the influencing factors of DFS were analyzed by univariate and multivariate Cox regression.Cut-off values were extracted,and Kaplan-Meier curves were used for survival analysis.Results Maximum 3D diameter(HR=1.829,95%CI 1.389-2.408,P<0.001)and spherical disproportion(HR=2.153,95%CI 1.474-3.146,P<0.001)were independent risk factors for DFS in primary gastric GIST.Kaplan-Meier curves showed that patients with maximum 3D diameter>90.5 mm and spherical disproportion>1.5 showed shorter DFS after curative resection(P<0.001).Conclusion Maximum 3D diameter and spherical disproportion based on preoperative enhanced CT are valuable in the diagnosis of postoperative DFS in primary gastric GIST.
作者
陈晓姗
陈杰军
杨雨涛
周建军
饶圣祥
CHEN Xiaoshan;CHEN Jiejun;YANG Yutao;ZHOU Jianjun;RAO Shengxiang(Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Medical Imaging,Shanghai 200032,China;Department of Radiology,The Third Affiliated Hospital,Sun Yat-sen University,Guangzhou 510630,Guangdong,China;Department of Radiology,Zhongshan Hospital(Xiamen Branch),Fudan University,Xiamen 361015,Fujian,China)
出处
《中国临床医学》
2024年第5期804-810,共7页
Chinese Journal of Clinical Medicine
基金
中华国际医学交流基金会2020 SKY影像科研基金(Z-2014-07-2003-04)。
关键词
胃肠道间质瘤
计算机断层成像
无病生存期
最大三维直径
球面歧化
gastrointestinal stromal tumors
computed tomography
disease-free survival
maximum 3D diameter
spherical disproportion
