Abstract：Objective: To study the CT applied value in the diagnosis of gastrointestinal stromal tumor, and observe its performance and the relationship with immunohistochemical, so as to provide reference for staging for clinical diagnosis and treatment plan. Methods: 80 cases of gastrointestinal stromal tumors confirmed by operation and pathology in our hospital from April 2014 to April 2017 were selected as the research objects, including 48 cases of gastric lesions, 23 cases of small intestinal lesions, 7 cases of abdominal lesions, 1 case of esophageal lesions, 1 case of retroperitoneal lesions. All patients underwent CT scan. The location, size, shape, border, growth pattern, necrosis degree and calcification of the tumor were statistically analyzed, and compared with immunohistochemical typing. Results: In 80 patients, there were 24 cases, 19 cases, 9 cases and 28 cases of smooth muscle differentiation, nerve orientation differentiation, smooth muscle and nerve bidirectional differentiation and lack of differentiation. Eighty patients had 85 gastrointestinal stromal tumors, of which 40 were diameter less than 5cm, and 31 lesions were 5 ~ 10cm in diameter. The diameter of 14 lesions was more than 10cm. The contour of 52 lesions was fairly regular, and 33 lesions were irregular or lobule. The boundaries of 72 lesions were clear and 13 lesions were not clearly defined by the adhesion or infiltration of the surrounding area. 55 lesions were exogenous, 20 lesions were cross-wall growth, and 10 lesions were endogenous. There was no obvious necrosis in 40 lesions, 27 lesions were focal necrosis, and 18 lesions had extensive necrosis. Smooth muscle mass direction differentiation group > 10cm in diameter, mass increase, the mass proportion of extensive necrosis was obviously higher than that of neural differentiation of direction group, the smooth muscle and nerve two-way characteristics, lack of differentiation groups (P<0.05). Conclusion: CT examination is a clinical diagnosis of gastrointestinal stromal tumor is an effective way, to the CT manifestation of gastrointestinal stromal tumor give careful observation to determine tumor immune group tumble type, it is of great use value and significance, can further promote the use.
[1] 刘琦,徐凯,韩翠萍,等.胃肠道间质瘤少见CT表现[J].徐州医学院学报,2016,(3):184~187. [2] Joensuu H, Eriksson M, Sundby Hall K, et al. Adjuvant imatinib for high-risk GI stromal tumor: analysis of a randomized trial[J].Journal of Clinical Oncology, 2015, 34(3): 244~250. [3] 宋彬, 杜娟,王银萍.胃肠道间质瘤临床病理诊断研究进展[J].中华实用诊断与治疗杂志,2015,29(2):117~119. [4] Peterson L W, Artis D. Intestinal epithelial cells: regulators of barrier function and immune homeostasis[J].Nature reviews, 2014, 14(3): 141. [5] 买尔旦,赛力木,金钟,等.胃肠道间质瘤的临床病理特征及预后相关因素分析[J].继续医学教育,2014,28(4):39~41. [6] Afshar M, Hamilton P, Seligmann J, et al. Can D-Dimer measurement reduce the frequency of radiological assessment in patients receiving palliative imatinib for gastrointestinal stromal tumor (GIST)[J].Cancer Investigation, 2015, 33(8): 347~353. [7] 王勇炫.胃肠道良恶性间质瘤CT征象和临床病理对照分析[J].数理医药学杂志,2017,(1):17~19. [8] Miyake K K, Nakamoto Y, Kataoka T R, et al. Clinical, morphologic, and pathologic features associated with increased FDG uptake in schwannoma[J].American Journal of Roentgenology, 2016, 207(6): 1288~1296. [9] 董春龙.胃肠道间质瘤的临床病理特征与免疫组织学特征[J].现代诊断与治疗,2017,(6):1087~1088. [10] Ricci R, Martini M, Cenci T, et al. Divergent gastrointestinal stromal tumors in syndromic settings[J].Cancer Genetics, 2016, 209(7): 354~358. [11] 王帆荣,陈芸,赵艳红,等.胃肠道间质瘤的临床病理特征及危险度分级的影响因素[J].临床与病理杂志,2017,37(4):748~753. [12] 刘秋雨,缑向南,阚云珍,等.胃肠道间质瘤合并良恶性消化系统肿瘤的临床病理及分子遗传学特征[J].临床与实验病理学杂志,2014,30(10):1166~1169. [13] Tian Y T, Liu H, Shi S S, et al. Malignant extra-gastrointestinal stromal tumor of the pancreas: report of two cases and review of the literature[J].World Journal of Gastroenterology, 2014, 20(3): 863. [14] 黄伟康,唐西平,吴志彬,等.16排螺旋CT在胃肠道疾病诊治中的临床应用分析[J].实用医技杂志,2016,23(3):235~237. [15] Tan Y, Garcia-Buitrago M T, Trent J C, et al. The immune system and gastrointestinal stromal tumor: a wealth of opportunities[J].Current Opinion in Oncology, 2015, 27(4): 338~342. [16] 武超颖,舒健,韦思平.不同生长类型胃肠间质瘤CT表现与病理分级对比分析[J].中国医学创新,2014,11(7):12~14. [17] 任春红,任东杰,王仕莲.胃肠间质瘤应用超声内镜的诊断及治疗价值分析[J].现代诊断与治疗,2015,26(12):2754~2755.
2018, Vol. 24 
冀公网安备13080202000786号