背景:胃肠道间质瘤(GIST)是一种罕见的胃肠道间质瘤,具有潜在的恶性。一旦肿瘤破裂,无论肿瘤大小和有丝分裂数,它可以被识别为高危人群。这对诊断具有重要意义,治疗,如果可以在手术前进行非侵入性检查以准确评估肿瘤的风险,则GIST的预后。
目的:确定与GIST破裂和病理风险相关的因素。
方法:50名GIST患者的队列,经术后病理证实,是从我们医院挑选的。收集患者的临床病理和计算机断层扫描数据。采用Logistic回归分析评价GIST破裂及病理危险分级的相关因素。
结果:病理风险等级,肿瘤直径,肿瘤形态学,内部坏死,气液界面,Ki-67指数与GIST破裂有显著相关性(P<0.05)。性别,肿瘤直径,肿瘤破裂,发现Ki-67指数与GIST的病理风险分级相关(P<0.05)。多因素logistic回归分析显示,男性和肿瘤直径≥10cm是GIST病理风险分级的独立预测因素[比值比(OR)=11.12,95%置信区间(95CI):1.81-68.52,P=0.01;OR=22.96,95CI:2.19-240.93,P=0.01]。肿瘤直径≥10cm,不规则形状,内部坏死,气液界面,和Ki-67指数≥10是GIST破裂高风险的独立预测因子(OR=9.67,95CI:2.15-43.56,P=0.01;OR=35.44,95CI:4.01-313.38,P<0.01;OR=18.75,95CI:3.40-103.34,P<0.01;OR=27.00,95CI:3.10-235.02,P<0.01,4.95CI=1.95=
结论:肿瘤直径,肿瘤形态学,内部坏死,气液,Ki-67指数与GIST破裂有关,而性别和肿瘤直径与GIST的病理风险有关。这些发现有助于我们对GIST的理解,并可能为这种情况的非侵入性检查策略和风险评估提供信息。
BACKGROUND: Gastrointestinal stromal tumor (GIST) is a rare gastrointestinal mesenchymal tumor with potential malignancy. Once the tumor ruptures, regardless of tumor size and mitotic number, it can be identified into a high-risk group. It is of great significance for the diagnosis, treatment, and prognosis of GIST if non-invasive examination can be performed before surgery to accurately assess the risk of tumor.
OBJECTIVE: To identify the factors associated with GIST rupture and pathological risk.
METHODS: A cohort of 50 patients with GISTs, as confirmed by postoperative pathology, was selected from our hospital. Clinicopathological and computed tomography data of the patients were collected. Logistic regression analysis was used to evaluate factors associated with GIST rupture and pathological risk grade.
RESULTS: Pathological risk grade, tumor diameter, tumor morphology, internal necrosis, gas-liquid interface, and Ki-67 index exhibited significant associations with GIST rupture (P < 0.05). Gender, tumor diameter, tumor rupture, and Ki-67 index were found to be correlated with pathological risk grade of GIST (P < 0.05). Multifactorial logistic regression analysis revealed that male gender and tumor diameter ≥ 10 cm were independent predictors of a high pathological risk grade of GIST [odds ratio (OR) = 11.12, 95% confidence interval (95%CI): 1.81-68.52, P = 0.01; OR = 22.96, 95%CI: 2.19-240.93, P = 0.01]. Tumor diameter ≥ 10 cm, irregular shape, internal necrosis, gas-liquid interface, and Ki-67 index ≥ 10 were identified as independent predictors of a high risk of GIST rupture (OR = 9.67, 95%CI: 2.15-43.56, P = 0.01; OR = 35.44, 95%CI: 4.01-313.38, P < 0.01; OR = 18.75, 95%CI: 3.40-103.34, P < 0.01; OR = 27.00, 95%CI: 3.10-235.02, P < 0.01; OR = 4.43, 95%CI: 1.10-17.92, P = 0.04).
CONCLUSIONS: Tumor diameter, tumor morphology, internal necrosis, gas-liquid, and Ki-67 index are associated with GIST rupture, while gender and tumor diameter are linked to the pathological risk of GIST. These findings contribute to our understanding of GIST and may inform non-invasive examination strategies and risk assessment for this condition.