分子影像学杂志2025，Vol.48Issue(9)：1115-1120,6.DOI:10.12122/j.issn.1674-4500.2025.09.09
多期增强CT影像对预测胃肠道间质瘤Ki-67指数高表达的价值
The value of multiphase contrast-enhanced CT in predicting high Ki-67 expression in gastrointestinal stromal tumors
摘要
Abstract
Objective To evaluate the diagnostic efficacy and predictive value of CT imaging features in identifying gastrointestinal stromal tumors(GIST)with high Ki-67 proliferation index expression.Methods In this retrospective study,we analyzed clinical and imaging data from 638 pathologically confirmed GIST cases at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from January 2016 to December 2023.Patients were stratified into low-Ki-67(n=539)and high-Ki-67(n=99)groups based on postoperative immunohistochemical results.Potential associations between CT characteristics and Ki-67 status were initially screened through univariate analysis,followed by multivariate logistic regression to identify independent predictors.A composite predictive model was subsequently developed and evaluated using ROC curve analysis,with particular attention to the area under the curve(AUC),sensitivity,and specificity.Results Univariate analysis demonstrated significant correlations between high Ki-67 expression and multiple CT features including:tumor size,irregular shape,cystic changes,necrosis,surface ulceration,intratumoral hemorrhage,heterogeneous enhancement,and intratumoral neovascularization(P<0.05).Multivariate logistic regression analysis established tumor size,surface ulceration,and intratumoral hemorrhage as independent predictive factors.The combined model incorporating these three features achieved an AUC of 0.750(95%CI:0.696-0.804),with sensitivity and specificity of 81.32%and 59.68%,respectively.Conclusion The combined evaluation of tumor size,surface ulceration,and intratumoral hemorrhage on CT imaging serves as an effective predictor of elevated Ki-67 expression in GIST patients.This imaging-based triage approach enables reliable identification of high Ki-67 cases.关键词
胃肠道间质瘤/增殖指数/计算机断层扫描/影像特征Key words
gastrointestinal stromal tumor/proliferation index/computed tomography/imaging features引用本文复制引用
彭刚,施玉婷,吴言,孙继红..多期增强CT影像对预测胃肠道间质瘤Ki-67指数高表达的价值[J].分子影像学杂志,2025,48(9):1115-1120,6.基金项目
浙江省"领雁"研发攻关计划项目(2024C03047) （2024C03047）
