摘要
目的探讨术前血液炎症指标及增强CT与胃肠道间质瘤(GIST)危险度分级的相关性,分析其对GIST危险度分级的诊断效能。方法回顾性收集2022年3月~2024年3月盐城市第一人民医院经病理证实并按美国国立卫生研究院2008改良版标准分级的148例GIST患者的资料,分析其术前的血清炎症指标[中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、系统免疫炎症指数(SII)]及CT增强图像特征[肿瘤长径、肿瘤部位、强化方式、肿瘤形态、瘤内坏死或囊变、钙化、溃疡],并将患者分为低风险组(n=73,极低危、低危)与高风险组(n=75,中危、高危),比较低、高风险组相关指标的差异性,采用Spearman相关性分析炎症指标、增强CT特征与GIST危险度分级的相关性。结果NLR、PLR、SII、肿瘤长径、肿瘤部位、瘤内坏死或囊变、强化方式、肿瘤形态与危险度分级呈正相关,其诊断为高风险组的最佳临界值分别为NLR>2.285(AUC=0.741),PLR>167.135(AUC=0.654),SII>410.495(AUC=0.711),肿瘤长径>4.65(AUC=0.931),多指标联合预测效能最高(AUC=0.941)。结论基于术前血清炎症指标联合增强CT可以较好地预测GIST的危险度分级,以联合诊断效能最优,为患者制订个性化方案提供参考。
Objective To investigate the correlation between preoperative serum inflammatory indicators combined with enhanced CT image features and the risk classification of gastrointestinal stromal tumor(GIST),and analyze its diagnostic efficacy for GIST risk classification.Methods A lot of 148 patients with pathologically confirmed GISTs were collected from March 2022 to March 2024 in Yancheng First People's Hospital and classified according to the National Institutes of Health revised criteria.Preoperative serum inflammatory indicators[neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),systemic immunoinflammatory index(SII)]and enhanced CT image features[tumor length,tumor location,enhancement pattern,shape,intratumor cystic or necrosis,calcification,surface ulcer]were retrospectively analyzed.These patients were divided into low risk group(n=73,very low risk,low risk)and high risk group(n=75,intermediate risk,high risk).The differences of relevant indicators between low and high risk groups were compared,and Spearman correlation was used to analyze the correlation between inflammatory indicators,enhanced CT image features and risk classification.Results NLR,PLR,SII,tumor length,tumor location,intratumoral cystic or necrosis,enhancement pattern,and shape were positively correlated with different risk classification.The optimal cut-off values for high risk group were NLR>2.285(AUC=0.741),PLR>167.135(AUC=0.654),SII>410.495(AUC=0.711),tumor length>4.65(AUC=0.931),the AUC of combining multi-indexes was 0.941,better than the above single index.Conclusion Preoperative serum inflammatory indicators combined with enhanced CT imaging features can better predict the risk classification of GIST,the combined diagnosis has the best efficiency,and provides reference for patients to make personalized plan.
作者
耿其楠
王曼曼
邵超
汪洁
江舒
陈望
GENG Qinan;WANG Manman;SHAO Chao;WANG Jie;JIANG Shu;CHEN Wang(Department of Radiology,Yancheng No.1 People's Hospital,Affiliated Hospital of Medical School,Nanjing University(The First People's Hospital of Yancheng),Yancheng 224000,China;Jiangsu Vocational College of Medicine,Yancheng 224000,China)
出处
《分子影像学杂志》
2024年第12期1377-1382,共6页
Journal of Molecular Imaging
基金
盐城市科技局基础研究计划(YCBK2023029)
盐城市科技局重点研发计划(社会发展)(YCBE202212)。
关键词
胃肠道间质瘤
血清炎症标志物
危险度分级
X线计算机
gastrointestinal stromal tumor
serum inflammatory indicators
risk classification
X-ray computed
作者简介
耿其楠,硕士,主治医师,E-mail:845016522@qq.com;通信作者:陈望,硕士,副主任医师,E-mail:chen13319@126.com。
