双能CT对胃间质瘤中Ki-67表达的预测价值及其与病理参数的关系

目的 探讨双能CT对胃间质瘤中Ki-67表达的预测价值及其与病理参数的关系。方法 回顾性选取2019年2月至2020年4月期间收治胃间质瘤患者82例,进行双能CT检查、Ki-67表达测定,根据Ki-67表达指数分为两组,即39例高表达组(Ki-67表达>6%)、43例低表达组(Ki-67表达≤6%),分析两组临床病理特征,对比不同Ki-67表达下CT间各参数值,用ROC曲线分析CT间各参数值对Ki-67表达含量的预测价值,同时用Pearson法分析Ki-67指数与临床病理参数相关性。结果 高表达组动脉期和静脉期的40 ke V CT值、50 ke V CT值、60 ke V CT值、70 ke V CT值、IC值、NIC值均高于低表达组(P<0.05)。ROC曲线分析表明,静脉期40 ke V CT值、50 ke V CT值、60 ke V CT值、70 ke V CT值、IC值、NIC值鉴别Ki-67表达含量的AUC依次为0.867、0.907、0.939、0.758、0.952、0.854;动脉期各参数鉴别Ki-67表达含量的AUC依次为0.998、0.944、0.967、0.888、0.925、0.764。经Pearson法分析,Ki-67指数与各参数均呈负相关,与单发/多发、核分裂象、有无出血、肿瘤部位呈负相关,与危险度分级呈正相关。结论 双能CT动静脉期的40、50、60、70CT值以及IC值、NIC值与Ki-67指数呈负相关,可反映胃间质瘤细胞增殖程度,同时Ki-67表达可作为评估胃间质瘤预后、危险度分级的重要参考指标。

Predictive value of dual-energy CT for Ki-67 expression in gastric stromal tumors and relationship with pathological factors

Objective To explore the predictive value of dual-energy CT for Ki-67 expression in gastric stromal tumors(GST) and its relationship with pathological factors. Methods Totally 82 GST patients admitted from February 2019 and April 2020 were retrospectively selected. Dual-energy CT were performed to measure Ki-67, the patients were divided into two groups based on Ki-67 expression, namely 39 cases in high expression group (Ki-67>6%), 43 cases in low expression group (Ki-67≤6%). Pathological factors were analyzed in between groups, and CT parameters were compared between Ki-67 different expressions. Receiver operating characteristic(ROC) curve analysis were used to analyze the predictive value of CT parameters, the correlation between Ki-67 index expression and pathological factors by Pearson's correlation coefficient. Results The values of each phase (40 keV, 50 keV, 60 keV, 70 keV) and iodine concentration(IC), normalized iodine concentration(NIC) on arterial and venous phase were higher in high expression group than in concurrent low expression group (P<0.05). The area under curve(AUC) of the parameters to identify Ki-67 expression on venous phase were 0.867, 0.907, 0.939, 0.758, 0.952 and 0.854, respectively, and with 0.998, 0.944, 0.967, 0.888, 0.925 and 0.764 on arterial phase, respectively. Pearson's correlation analysis showed Ki-67 expression were negatively correlated with the parameters. Meanwhile the indexes negatively correlated with single/multiple, nuclear division, with or without bleeding, tumor location. A positively correlated was found between Ki-67 expression and the risk classification.Conclusion Dual-energy CT value of each phase (40 keV, 50 keV, 60 keV, 70 keV), and IC value, NIC value on arterial and venous phase are negatively correlated with Ki-67 expression, which may reflect GST cell proliferation, moreover Ki-67 expression can use to be an important reference index for prognosis and risk grading of GST.