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Title: [Correlation between the CT features and malignancy risk of small (≤5 cm) gastric stromal tumors].
Author: Wang J, Xu JL, Hu HJ.
Journal: Zhonghua Zhong Liu Za Zhi; 2017 Mar 23; 39(3):184-189. PubMed ID: 28316216.
Abstract:
Objective: To evaluate the correlation between computed tomography (CT) features and malignancy risk category of small (≤5 cm) gastric stromal tumors (GST), in order to provide an image reference for preoperative assessment and intraoperative pathological diagnosis. Methods: Eighty-three patients with surgically and pathologically proven GST (≤5 cm) between January 2011 and November 2015 were recruited, and their clinical, pathological and CT data were retrospectively analyzed. According to the pathological results and malignancy risk category, the patients were divided into 2 groups, the benign biological behavior group (very low and low risk) and malignant biological behavior group (intermediate and high risk). The clinical, pathological and CT imaging findings of the two groups were analyzed. Based on the tumor diameter, the receiver operating characteristic curve (ROC) was applied to evaluate the sensitivity, specificity and the best cut-off point for distinguishing the malignancy risk between the two groups. Results: The lobulation and ulceration of the tumors presented statistically significant difference for the malignancy risk between the two groups (χ(2)=6.273 and 4.163, respectively; all P<0.05), but there was no significant difference in the sex, clinical symptoms, serum ferritin, tumor site, growth pattern, cystis degeneration and calcification (all P>0.05). No statistically significant differences were detected for the tumor CT value, arterial CT value, venous CT value, degrees of enhancement in arterial phase (DEAP), enhancement in portal venous phase (DEPP), and patient's age for distinguishing the malignancy risk between the two groups (all P>0.05). On the other hand, significant differences were found in the maximum diameter (Dmax) of tumor and the minimum diameter (Dmin) of tumor (t=-3.256 and -3.466, respectively; all P<0.05). When the cut-off point of Dmax was 1.6 cm, the area under the ROC curve, sensitivity and specificity were 0.704, 92.3% and 75.4%, respectively. When the cut-off point of Dmin was 1.5 cm, the area under the ROC curve, sensitivity and specificity were 0.713, 88.5% and 71.9%, respectively. Conclusion: CT features of the GST (≤5 cm) may predict, before surgery, the malignancy risk of small gastric stromal tumors, and provide the an image reference for preoperative assessment and intraoperative pathological diagnosis of the disease. 目的： 探讨≤5 cm胃间质瘤(GST)的CT表现及其与肿瘤危险度分级的相关性，为患者的术前评估及术中病理诊断提供影像学参考。 方法： 回顾性分析2011年1月至2015年11月经手术病理证实的83例≤5 cm GST患者的临床、病理和影像学资料。依据病理结果和肿瘤危险度将患者分为生物学行为倾向良性组(极低和低危险度组)以及生物学行为倾向恶性组(中和高危险度组)，分析两组患者的临床、病理及影像学特征。采用受试者工作特征曲线(ROC)分析肿瘤直径在区分两组患者肿瘤危险度间的最佳临界值、敏感度和特异度。 结果： 极低和低危险度组患者与中和高危险度组患者的肿瘤在分叶和溃疡方面的差异有统计学意义(均P<0.05)，在性别、临床症状、血清铁蛋白、肿瘤位置、生长方式、囊变和钙化方面的差异无统计学意义(均P>0.05)。极低和低危险度组患者与中和高危险度组患者的肿瘤在平扫CT值、动脉期CT值、静脉期CT值、动脉期增强幅度、静脉期增强幅度和患者年龄方面的差异无统计学意义(均P>0.05)，在肿瘤最大径和最小径方面的差异有统计学意义(均P<0.05)。ROC曲线分析结果显示，以肿瘤最大径区别两组患者肿瘤危险度分级中的曲线下面积、最佳临界值、敏感度和特异度分别为0.704、1.6 cm、92.3%和75.4%，以肿瘤最小径区别两组患者肿瘤危险度分级中的曲线下面积、最佳临界值、敏感度和特异度分别为0.713、1.5 cm、88.5%和71.9%。 结论： 通过对≤5 cm GST的CT征象分析，可以间接地对肿瘤危险度进行术前预判，从而为患者的术前评估及术中病理诊断提供影像学参考。.

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