摘要
目的:应用多排螺旋CT(MSCT)增强检查对术前DNA错配修复缺陷/微卫星不稳定性(dMMR/MSI)胃癌的影像特征进行分析,寻找诊断dMMR/MSI胃癌的独立预测因素。资料与方法:回顾性分析我院经病理证实的dMMR/MSI胃癌(44例)及错配修复(完整型)/微卫星稳定(pMMR/MSS)胃癌(70例),所有患者术前均接受MSCT增强检查。收集记录每位患者肿瘤影像学信息(包括肿瘤位置、最大厚度、最大径线、平扫及各增强时相CT平均值、有无溃疡和坏死、有无浆膜侵犯和淋巴结转移等)。采用单因素分析和多因素Logistic回归方程,对两组数据进行统计分析。结果:在多因素Logistic回归分析中,4个CT特征是dMMR/MSI胃癌诊断的独立预测因素,包括瘤灶低动脉期增强斜率(OR:0.010;95%CI:0.002~0.066;P<0.001)、小瘤灶最大厚度(OR:0.111;95%CI:0.021~0.584;P=0.009)、无浆膜侵犯(OR:0.080;95%CI:0.015~0.431;P=0.003)、无瘤灶溃疡(OR:0.098;95%CI:0.016~0.597;P=0.012)。结论:MSCT增强检查可预测dMMR/MSI胃癌,为临床治疗方案选择和预后判断提供参考。
Objective:To explore the imaging features of dMMR/MSI gastric cancer before operation by enhanced multi-slice spiral CT,and to find the independent predictive factors for the diagnosis of dMMR/MSI gastric cancer.Materials and Methods:Forty-four cases of dMMR/MSI gastric cancer and 70 cases of pMMR/MSS gastric cancer confirmed by pathology in our hospital were retrospectively analyzed,and all patients underwent enhanced MSCT examination before surgery.The tumor imaging information of each patient(including tumor location,maximum thickness,maximum diameter,CT average value of plain scan and each enhancement phase,presence or absence of ulcer and necrosis,presence or absence of serous invasion and lymph node metastasis)were collected and recorded.Univariate analysis and multivariate Logistic regression equation were used for statistical analysis of the two groups of data.Results:In multivariate Logistic regression analysis,4 CT features were independent predictors of dMMR/MSI gastric cancer diagnosis,including the low arterial phase enhancement slope(OR:0.010;95%CI:0.002~0.066;P<0.001),the maximum thickness of small tumor(OR:0.111;95%CI:0.021~0.584;P=0.009),no serosa invasion(OR:0.080;95%CI:0.015~0.431;P=0.003),no ulcer(OR:0.098;95%CI:0.016~0.597;P=0.012).Conclusion:En-hanced MSCT examination can predict dMMR/MSI gastric cancer,and provide reference for clinical treatment plan selection and prognosis judgment.
作者
黄喆
陈伟志
HUANG Zhe;CHEN Wei-zhi(Department of Radiology,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou Liaoning 121000,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2023年第5期349-352,359,共5页
Journal of China Clinic Medical Imaging
基金
2019年辽宁省科技厅计划项目指导项目(2019JH8/10300035)。
