Correlation of computed tomography features with tumor grade of gastrointestinal stromal tumor

doi:10.3877/cma.j.issn.1674-0793.2013.06.010

Abstract

Abstract:

Objective

To analyze the computed tomography(CT) features of the gastrointestinal stromal tumor (GIST) and to estimate the CT features for assisting the pathologic classification of GIST.

Methods

The data of fifty-eight patients with pathologically and immunohistochemically proven GISTs were collected, including 41 patients with malignant tumors and 17 patients with benign or malignant potential tumors, who underwent examination of CT for primary tumors. The effect of CT features to the classification of the GIST was analyzed.

Results

Malignant GISTs were significantly more common in the small intestine and rectum than in the stomach and esophagus. Fifty GISTs extending outside or among the wall, 38 of them were malignant tumors. The mean tumor size was 7.5 cm. Twenty-six were larger than 7.5 cm and 23 of them were malignant. Thirty-five had irregular surface and among them, 30 were malignant. All the benign or malignant potential tumors had clear boundary, and 19 cases of malignant GIST had unclear boundary. Forty-one of malignant GIST and 10 cases of benign or malignant potential tumors showed heterogeneous enhancement. All the malignant GIST and 10 of benign or malignant potential GIST demonstrated necrosis. Fifteen of malignant GIST demonstrated circumference invasion. Five patients had hepatic metastases and 1 had peritoneal dissemination. There were no significant differences between malignant and benign or malignant potential GIST about the tumor enhancement, tumor vessel, inner layer enhancement or ulcer.

Conclusion

CT plays an important role in the preoperational diagnosis and classification of GIST.

Key words: Gastrointestinal stromal tumor, Pathology, Classification, Computed tomography

Zhen-peng PENG, Can-hui SUN, Yan-ji LUO, Zhi DONG, Xue-hua LI, Zi-ping LI, Shi-ting FENG. Correlation of computed tomography features with tumor grade of gastrointestinal stromal tumor[J]. Chinese Archives of General Surgery(Electronic Edition), 2013, 07(06): 461-465.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2013.06.010

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2013/V07/I06/461

Figures/Tables 2

References 10

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肿瘤部位	良性及交界性（17例）	恶性（41例）
食管	3	0
胃	12	20
十二指肠	1	3
空肠	0	6
回肠	0	5
结肠	0	0
直肠	0	6
肠系膜	1	1

肿瘤部位	良性及交界性（17例）	恶性（41例）
食管	3	0
胃	12	20
十二指肠	1	3
空肠	0	6
回肠	0	5
结肠	0	0
直肠	0	6
肠系膜	1	1

CT征象		病理分级			χ ²值	P值
CT征象		良性及交界性	恶性	合计	χ ²值	P值
生长方式		5	3	8	4.934	0.026
?	腔内生长	?	?	?	?	?
?	腔外及壁间生长	12	38	50	?	?
最大径（cm）		?	?	?	?	?
?	≥7.5	3	23	26	7.184	0.007
?	<7.5	14	18	32	?	?
形态		?	?	?	?	?
?	类圆形	12	11	23	9.616	0.002
?	分叶状	5	30	35	?	?
边界		?	?	?	?	?
?	清晰	17	19	36	14.696	0.000
?	不清或部分不清	0	22	22	?	?
钙化		?	?	?	?	?
?	有	0	6	6	1.421	0.233
?	无	17	35	52	?	?
强化形式^a		?	?	?	?	?
?	均匀	6	0	6	13.433	0.000
?	不均匀	10	41	51	?	?
强化程度^a		?	?	?	?	?
?	明显	10	22	32	0.365	0.546
?	轻度	6	19	25	?	?
坏死		?	?	?	?	?
?	有	10	41	51	15.516	0.000
?	无	7	0	7	?	?
坏死形式		?	?	?	?	?
?	大片状	2	19	21	6.220	0.013
?	小点、斑片状或无坏死	15	22	37	?	?
表面血管^a		?	?	?	?	?
?	有	9	29	38	1.086	0.297
?	无	7	12	19	?	?
瘤内血管^a		?	?	?	?	?
?	有粗大瘤内血管	4	14	18	0.446	0.504
?	无粗大瘤内血管	12	27	39	?	?
表面黏膜强化		?	?	?	?	?
?	有	4	4	8	1.133	0.287
?	无	12	37	49	?	?
溃疡		?	?	?	?	?
?	有	4	12	16	0.015	0.903
?	无	13	29	41	?	?
周围侵犯		?	?	?	?	?
?	有	0	15	15	6.589	0.010
?	无	17	26	43	?	?

CT征象		病理分级			χ ²值	P值
CT征象		良性及交界性	恶性	合计	χ ²值	P值
生长方式		5	3	8	4.934	0.026
?	腔内生长	?	?	?	?	?
?	腔外及壁间生长	12	38	50	?	?
最大径（cm）		?	?	?	?	?
?	≥7.5	3	23	26	7.184	0.007
?	<7.5	14	18	32	?	?
形态		?	?	?	?	?
?	类圆形	12	11	23	9.616	0.002
?	分叶状	5	30	35	?	?
边界		?	?	?	?	?
?	清晰	17	19	36	14.696	0.000
?	不清或部分不清	0	22	22	?	?
钙化		?	?	?	?	?
?	有	0	6	6	1.421	0.233
?	无	17	35	52	?	?
强化形式^a		?	?	?	?	?
?	均匀	6	0	6	13.433	0.000
?	不均匀	10	41	51	?	?
强化程度^a		?	?	?	?	?
?	明显	10	22	32	0.365	0.546
?	轻度	6	19	25	?	?
坏死		?	?	?	?	?
?	有	10	41	51	15.516	0.000
?	无	7	0	7	?	?
坏死形式		?	?	?	?	?
?	大片状	2	19	21	6.220	0.013
?	小点、斑片状或无坏死	15	22	37	?	?
表面血管^a		?	?	?	?	?
?	有	9	29	38	1.086	0.297
?	无	7	12	19	?	?
瘤内血管^a		?	?	?	?	?
?	有粗大瘤内血管	4	14	18	0.446	0.504
?	无粗大瘤内血管	12	27	39	?	?
表面黏膜强化		?	?	?	?	?
?	有	4	4	8	1.133	0.287
?	无	12	37	49	?	?
溃疡		?	?	?	?	?
?	有	4	12	16	0.015	0.903
?	无	13	29	41	?	?
周围侵犯		?	?	?	?	?
?	有	0	15	15	6.589	0.010
?	无	17	26	43	?	?

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