胃肠间质瘤的CT表现及其对预后评估的价值

目的探讨胃肠间质瘤（GIST）CT征象对GIST患者预后评估的价值。方法收集有完整cT及病理组织学资料的38例原发GIST患者临床资料，统计不同cT征象与患者预后的关系。结果38例患者均获随访，平均随访时间42．6个月，3年生存率为86．8％。生存分析显示，GIST生长方式、最大径、形态、边界、坏死形式、溃疡形成、周围侵犯及肝转移等CT征象可明显影响患者术后3年生存率（均P〈0．05）。但GIST钙化与否与强化程度则与预后无关（均P〉0．05）。结论cT检查能充分显示GIST肿瘤内部情况和相邻组织关系，能判断肿瘤坏死、出血、肿瘤内细小钙化、局部浸润和远处转移，对GIsT患者预后的评估有重要的作用。

Value of computed tomography features for prognosis evaluation of gastrointestinal stromal tumor

Objective To analyze the association between CT features and survival rate of GIST, and to elucidate the significance of CT features for prognosis. Methods Clinical data of 38 patients with pathologically and immunohistochemically proven GISTs, including 11 patients at high biological risk, 13 at moderate risk, 10 at low risk and 4 at very low risk. Patients who underwent CT examination for primary tumors were included. Association between CT features and survival rate was examined. Results The mean follow-up period of 38 cases was 42.6 months and the 3-year survival rate was 86.8%. Univariate analysis revealed that tumor growth pattern, diameter, lobulated shape, irregular margin, necrosis, ulceration, adjacent invasion, and liver metastasis were associated factors of 3-year survival rate. Circumference invasion and hepatic metastases predicted poor 3-year survival rate （P〈0.05）. Calcification and intensity were not associated with prognosis （P〉0.05）. Conclusions CT can demonstrate the tumor growth pattern, size, shape, boundary, density, necrosis, hemorrhage, calcification, ulcer, enhance features and metastasis. CT can play an important role in estimating the survival rate of GIST.