Correlation of Ki-67 expression with MSCT signs and risk grading in small intestinal stromal tumors
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摘要:
目的探讨小肠间质瘤(SIST)组织中的Ki-67表达与多层螺旋CT(MSCT)表现、危险分级的相关性。 方法回顾性分析87例经手术病理证实的SIST的临床病理、免疫组化及影像学资料,探讨SIST组织中Ki-67表达与CT表现、危险分级的关系。 结果在单因素方差分析中,Ki-67表达在部位、形态、大小、浸润转移、病理分组及核分裂像方面差异具有统计学意义(P < 0.05);性别、年龄、临床特征、囊变或坏死、溃疡、生长方式、是否为肠系膜上动脉供血、动脉期强化程度、静脉期或延迟期强化方式均无统计学意义(P > 0.05)。多因素Logistic回归分析显示Ki-67表达5%~10%为亚组时,大小差异具有统计学意义(P < 0.05),以 < 2 cm为对照,其中2~5 cm分组OR值为2.179,5~10 cm分组OR值为4.345, > 10 cm分组OR值为7.698。 > 10%亚组,其中回肠与大小是影响高表达的独立影响因素(P < 0.05),回肠OR值为17.622;以 < 2 cm为对照,其中2~5 cm分组OR值为2.179,5~10 cm分组OR值为4.345, > 10 cm分组OR值为7.698。 结论SIST组织中的Ki-67表达与MSCT征象有一定的相关性,并且高危组、核分裂数较大的组织Ki-67表达更高,对SIST的临床治疗方案选择、预后判断具有一定的辅导意义。 Abstract:ObjectiveTo investigate the correlation of Ki-67 expression with MSCT findings and risk grade in small intestinal stromal tumor (SIST). MethodsThe clinicopathological, immunohistochemical and imaging data of 87 cases of SIST confirmed by surgery and pathology were retrospectively analyzed to explore the relationship between Ki-67 expression and CT findings and risk classification. ResultsIn one-way ANOVA, Ki-67 expression was significantly different in location, shape, size, invasion and metastasis, pathological group and mitotic image (P < 0.05); There was no significant difference in gender, age, clinical features, cystic degeneration or necrosis, ulcer, growth pattern, whether it was supplied by superior mesenteric artery, enhancement degree in arterial phase, enhancement mode in venous phase or delayed phase (P > 0.05). The Results of multivariate logistic regression analysis showed that the expression of Ki-67 was 5% to 10% in subgroups, the size was statistically significant (P < 0.05), and the control was less than 2 cm, of which the or value of 2-5 cm group was 2.179, or value of 5-10 cm group was 4.345, or value of greater than 10 cm group was 7.698. The or value of ileum was 17.622 in greater than 10% subgroup (P < 0.05), the or value of 2-5 cm subgroup was 2.179, 5-10 cm subgroup was 4.345, and greater than 10 cm subgroup was 7.698. ConclusionThe expression of Ki-67 in SIS is correlated with MSCT signs, and the expression of Ki-67 is higher in high-risk group and tissues with larger mitosis number, which has certain guiding significance for the selection of clinical treatment and prognosis of SIST. -
Key words:
- small intestine /
- stromal tumor /
- Ki-67 index /
- pathological risk classification /
- multi slice spiral CT
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表 1 Ki-67表达与患者MSCT征象的关系
Table 1. Relationship between Ki-67 expression and MSCT features[n(%)]
MSCT征象 Ki-67表达 χ2/F P 5%(n=36) 5%~10%(n=27) > 10(n=24) 部位 12.60 0.01 回肠 9(25.0) 4(14.8) 12(50.0) 空肠 20(55.6) 12(44.4) 10(41.7) 十二指肠 7(19.4) 11(40.7) 2(8.3) 形态 8.10 0.01 分叶状或不规则 16(44.4) 20(74.1) 18(75.0) 圆形或椭圆形 20(55.6) 7(25.9) 6(25.0) 大小(cm,Mean±SD) 5.71±4.79 8.13±5.74 10.20±6.19 4.91 0.01 囊变或坏死 2.87 0.23 有 16(44.4) 14(51.9) 16(66.7) 无 36(55.6) 27(48.1) 24(33.3) 溃疡 0.29 0.86 有 3(8.3) 3(11.1) 3(12.5) 无 33(91.7) 24(88.9) 21(87.5) 生长方式 7.82 0.09 腔内外型 12(33.3) 16(59.3) 15(62.5) 腔内型 10(27.8) 3(11.1) 2(8.3) 腔外型 14(38.9) 8(29.6) 7(29.2) 肠系膜上动脉分支供血 7.82 0.09 有 18(50.0) 17(63.0) 15(62.5) 无 18(50.0) 10(37.0) 9(37.5) 浸润或转移 7.63 0.02 有 6(16.7) 8(29.6) 12(50.0) 无 30(83.3) 19(70.4) 12(50.0) 动脉期强化程度(Hu) 2.01 0.73 < 20 6(16.7) 2(7.4) 5(20.8) 20~40 10(27.8) 9(33.3) 7(29.2) > 40 20(55.6) 16(59.3) 12(50.0) 静脉期及延迟期强化方式 2.31 0.31 减退 15(41.7) 16(59.3) 10(41.7) 渐进性强化 21(58.3) 11(40.7) 14(58.3) 表 2 Ki-67表达与临床及病理特征的关系
Table 2. Relationship between Ki-67 expression and clinical and pathological features[n(%)]
临床病理特征 Ki-67表达 χ2 P < 5%(n=36) 5%~10%(n=27) > 10%(n=24) 性别 4.95 0.08 男 21(58.3) 10(37.0) 16(66.7) 女 15(41.7) 17(63.0) 8(33.3) 年龄(岁,Mean±SD) 55.50±13.67 53.11±10.78 59.13±13.23 1.43 0.24 临床特征 3.04 0.56 消化道出血 21(58.3) 19(70.4) 13(54.2) 腹痛腹部不适 10(27.8) 7(25.9) 9(37.5) 无症状 5(13.9) 1(13.9) 2(8.3) 病理分组 21.20 < 0.01 高危组 10(27.8) 19(70.4) 20(83.3) 低危组 26(72.2) 8(29.6) 4(16.7) 核分裂像(个) 16.33 0.03 < 5 33(91.7) 17(63.0) 22(50.0) 5~10 2(5.6) 7(25.9) 5(20.8) > 10 1(2.8) 3(11.1) 7(29.2) 表 3 Ki-67表达影响因素的多元logistic回归
Table 3. Multiple logistic regression analysis on the influencing factors of Ki-67 expression
变量 β 标准误 Wald df P OR 95%CI 5%~10% 部位 回肠 1.043 1.097 0.903 1 0.342 2.836 0.330~24.351 空肠 0.716 0.751 0.909 1 0.340 2.047 0.470~8.922 十二指肠 对照 形态 分叶状或不规则 -0.081 0.857 0.009 1 0.924 0.922 0.172~4.945 圆形或椭圆形 对照 大小(cm) < 2 对照 2~5 0.779 0.713 8.129 0.034 2.179 0.539~8.811 5~10 1.469 0.892 8.752 < 0.001 4.345 0.757~24.953 > 10 2.041 0.901 10.991 < 0.001 7.698 1.317~45.015 浸润或转移 是 -0.030 0.909 0.001 1 0.974 0.970 0.163~5.760 否 对照 病理分组 高危组 -1.103 1.509 0.534 1 0.465 0.332 0.017~6.394 低危组 对照 核分裂像(个) < 5 1.816 1.286 1.993 1 0.158 6.148 0.494~76.511 5~10 0.393 1.533 0.066 1 0.798 1.482 0.073~29.916 > 10 对照 > 10% 部位 十二指肠 对照 回肠 2.869 1.052 7.439 1 0.006 17.622 2.242~138.509 空肠 1.373 .806 2.903 1 0.088 3.949 0.813~19.171 形态 圆形或椭圆形 对照 分叶状或不规则 -0.771 0.916 0.709 1 0.400 0.462 0.077~2.784 大小(cm) < 2 对照 2~5 0.779 0.713 8.129 0.034 2.179 0.539~8.811 5~10 1.469 0.892 8.752 < 0.001 4.345 0.757~24.953 > 10 2.041 0.901 10.991 < 0.001 7.698 1.317~45.015 浸润或转移 否 对照 是 1.226 0.875 1.963 1 0.161 3.409 0.613~18.959 病理分组 低危组 对照 高危组 0.833 1.655 0.253 1 0.615 2.300 0.090~58.913 核分裂像(个) > 10 对照 < 5 0.983 1.018 0.932 1 0.334 2.672 0.363~19.649 5~10 0.960 1.164 0.681 1 0.409 2.613 0.267~25.584 -
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