超聲胃鏡在胃間質(zhì)瘤的診斷及危險度分級中的價值
發(fā)布時間：2018-08-29 08:31
【摘要】：目的:回顧性分析超聲胃鏡在胃間質(zhì)瘤診斷中的價值,探討胃間質(zhì)瘤的潛在惡性危險度分級與年齡、性別、部位、內(nèi)部回聲情況及最大直徑的相關(guān)性,提高超聲胃鏡對胃間質(zhì)瘤危險度的評估,為患者的下一步臨床治療提供依據(jù)。方法:選取青島大學(xué)附屬醫(yī)院2015年6月-2016年10月期間超聲胃鏡下擬診為胃間質(zhì)瘤的病例共71例,病變均行手術(shù)切除治療,術(shù)后病理確診胃間質(zhì)瘤共46例,回顧性分析確診為胃間質(zhì)瘤的46例患者的臨床資料,根據(jù)病理結(jié)果,按照2001年美國國立衛(wèi)生研究院制定的GIST危險度分級標準將其分為高危組、中危組、低危組及極低危組四組,因胃間質(zhì)瘤的極低危組與低危組兩組在臨床生物學(xué)行為方面表現(xiàn)相近,且超聲胃鏡鏡下表現(xiàn)不易區(qū)分,故將其視為一組,以低危組表示,故本組究共分為三組,即高危組、中危組、低危組。通過統(tǒng)計學(xué)方法比較胃間質(zhì)瘤危險度分級與患者年齡、性別、腫瘤生長部位、內(nèi)部回聲情況及最大直徑等單一變量之間的關(guān)系。結(jié)果:EUS診斷胃間質(zhì)瘤的準確率為64.79%,病理確診的46例胃間質(zhì)瘤患者中,男女比例為1.09:1,年齡介于20-81歲,平均年齡57.9歲,臨床表現(xiàn)多樣,無癥狀者共22例,占47.8%,有癥狀者共24例,其中不明原因的腹痛、腹脹、早飽者共20例,占43.5%,出現(xiàn)黑便者共4例,占8.7%,腹部觸及腫塊者1例,占2.2%。根據(jù)胃間質(zhì)瘤的危險度分級標準對46例病例進行分組,其中高危組共5例,中危組共9例,低危組共32例,由統(tǒng)計學(xué)分析得出,年齡、性別均與腫瘤的危險度分級無關(guān)(P0.05);根據(jù)胃間質(zhì)瘤的生長部位分為胃底、胃體、胃竇組三組,其中病變位于胃底、胃體、胃竇部的分別為30例、12例、4例,各占65.22%、26.09%、8.69%,從數(shù)據(jù)中可看出,胃間質(zhì)瘤在胃底、胃體部的發(fā)病率較高;46例位于胃底部者低危組、中危組、高危組各21例、6例、3例;胃體部病變其低危組、中危組、高危組各8例、2例、2例;胃竇部病變其低危組、中危組、高危組各3例、1例、0例,由統(tǒng)計學(xué)分析得出,腫瘤的不同生長部位與其危險度分級無關(guān)(P0.05);根據(jù)超聲胃鏡下的腫瘤內(nèi)部回聲情況,將其分為回聲均勻組與不均勻組,高危組回聲均勻組0例,不均勻組5例,中危組回聲均勻組1例,不均勻組8例,低危組回聲均勻組13例,不均勻組19例,由統(tǒng)計學(xué)分析得出,腫瘤內(nèi)部回聲越不均勻,危險度分級越高(P0.05);超聲胃鏡下胃間質(zhì)瘤最大徑介于0.6-11.0cm,低危組直徑介于0.6-3.5cm,平均直徑為2.00cm;中危組直徑介于1.5-5.5cm,平均直徑為3.41cm;高危組直徑介于5.0-11.0cm,平均直徑7.22cm。通過統(tǒng)計學(xué)分析最終得出,腫瘤的直徑越大,危險度分級就越高(P0.05)。結(jié)論:超聲胃鏡是診斷胃間質(zhì)瘤最主要的方法,其準確率為64.79%,有較高的診斷價值;胃間質(zhì)瘤在胃底、胃體部的發(fā)病率高于胃竇部;本組研究顯示胃間質(zhì)瘤危險度分級與患者年齡、性別、腫瘤生長部位無關(guān),與病灶大小及內(nèi)部回聲相關(guān)。
[Abstract]:Objective: to retrospectively analyze the value of ultrasound gastroscopy in the diagnosis of gastric stromal tumors (GIST), and to explore the correlation between the classification of potential malignant risk and age, sex, location, internal echo and maximum diameter of gastric stromal tumors (GIST). To improve the risk assessment of gastric stromal tumors by ultrasound gastroscopy, and to provide the basis for the next clinical treatment of patients. Methods: a total of 71 cases of gastric stromal tumors (GIST) were selected from the affiliated Hospital of Qingdao University from June 2015 to October 2016. The lesions were surgically resected and 46 cases were confirmed by pathology after operation. The clinical data of 46 patients with gastric stromal tumors (GIST) were retrospectively analyzed. According to the pathological results, the patients were divided into high risk group, middle risk group, low risk group and very low risk group according to the GIST risk classification standard established by the National Institutes of Health in 2001. Because the very low risk group of gastric stromal tumor and the low risk group have similar clinical biological behavior, and it is difficult to distinguish them under ultrasound gastroscopy, they are regarded as one group, expressed as low risk group, so this group is divided into three groups: high risk group. Moderate risk group, low risk group. The relationship between the risk grade of gastric stromal tumor and single variables such as age, sex, tumor growth site, internal echo and maximum diameter was compared by statistical method. Results the accuracy rate of diagnosis of gastric stromal tumors was 64.79. The ratio of male to female was 1.09: 1 in 46 cases of gastric stromal tumors diagnosed by pathology. The average age was 57.9 years old. The average age was 57.9 years. There were 22 asymptomatic cases (47.8%) and 24 cases with symptoms. There were 20 cases (43.5%) with abdominal pain, abdominal distension and early satiety, 4 cases (8.7%) with black stool, 1 case (2.2%) with abdominal touching mass. According to the risk classification criteria of gastric stromal tumors, 46 cases were divided into high risk group (n = 5), middle risk group (n = 9) and low risk group (n = 32). According to the growth site of gastric stromal tumors, they were divided into three groups: gastric fundus, gastric body and antrum. The pathological changes in gastric fundus, gastric body and antrum were 30 cases, gastric body, and antrum respectively in 30 cases, 12 cases (4 cases), accounting for 65.220.26.09% (8.69%) respectively, as can be seen from the data. The incidence of gastric stromal tumors (GIST) in the fundus and body of stomach was higher in 46 patients with lower risk of gastric fundus, in the middle risk group, in the high risk group, 21 cases in the high risk group, 6 cases in the high risk group, 2 cases in the low risk group, 2 cases in the middle risk group, 8 cases in the high risk group, 2 cases in the low risk group and 2 cases in the high risk group, respectively. The low risk group, middle risk group and high risk group of gastric antral lesions had 1 case or 0 cases each. According to the statistical analysis, the different growth sites of the tumor were not related to its risk grade (P0.05); according to the echo of the tumor under the ultrasound gastroscopy, the tumor had no correlation with the risk grade (P0.05). They were divided into two groups: homogeneous echo group (n = 0), heterogeneous group (n = 5), moderate risk group (n = 1), heterogeneous group (n = 8), low risk group (n = 13) and heterogeneous group (n = 19). According to statistical analysis, the more uneven the echo inside the tumor, The maximum diameter of gastric stromal tumor was 0.6-11.0 cm under ultrasound gastroscopy, the diameter of low-risk group was 0.6-3.5 cm, the average diameter was 2.00 cm, the diameter of medium-risk group was 1.5-5.5 cm, the average diameter was 3.41 cm, and the diameter of high-risk group was 5.0-11.0 cm, the average diameter was 7.22 cm. Through statistical analysis, the larger the tumor diameter, the higher the risk grade (P0.05). Conclusion: ultrasonic gastroscopy is the most important method in the diagnosis of gastric stromal tumors, and its accuracy is 64.79, which has higher diagnostic value, and the incidence of gastric stromal tumors in the fundus and body of stomach is higher than that in antrum. The risk classification of gastric stromal tumors was not related to age, sex, tumor growth site, but to the size of the lesion and internal echo.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.2
本文編號：2210752
[Abstract]:Objective: to retrospectively analyze the value of ultrasound gastroscopy in the diagnosis of gastric stromal tumors (GIST), and to explore the correlation between the classification of potential malignant risk and age, sex, location, internal echo and maximum diameter of gastric stromal tumors (GIST). To improve the risk assessment of gastric stromal tumors by ultrasound gastroscopy, and to provide the basis for the next clinical treatment of patients. Methods: a total of 71 cases of gastric stromal tumors (GIST) were selected from the affiliated Hospital of Qingdao University from June 2015 to October 2016. The lesions were surgically resected and 46 cases were confirmed by pathology after operation. The clinical data of 46 patients with gastric stromal tumors (GIST) were retrospectively analyzed. According to the pathological results, the patients were divided into high risk group, middle risk group, low risk group and very low risk group according to the GIST risk classification standard established by the National Institutes of Health in 2001. Because the very low risk group of gastric stromal tumor and the low risk group have similar clinical biological behavior, and it is difficult to distinguish them under ultrasound gastroscopy, they are regarded as one group, expressed as low risk group, so this group is divided into three groups: high risk group. Moderate risk group, low risk group. The relationship between the risk grade of gastric stromal tumor and single variables such as age, sex, tumor growth site, internal echo and maximum diameter was compared by statistical method. Results the accuracy rate of diagnosis of gastric stromal tumors was 64.79. The ratio of male to female was 1.09: 1 in 46 cases of gastric stromal tumors diagnosed by pathology. The average age was 57.9 years old. The average age was 57.9 years. There were 22 asymptomatic cases (47.8%) and 24 cases with symptoms. There were 20 cases (43.5%) with abdominal pain, abdominal distension and early satiety, 4 cases (8.7%) with black stool, 1 case (2.2%) with abdominal touching mass. According to the risk classification criteria of gastric stromal tumors, 46 cases were divided into high risk group (n = 5), middle risk group (n = 9) and low risk group (n = 32). According to the growth site of gastric stromal tumors, they were divided into three groups: gastric fundus, gastric body and antrum. The pathological changes in gastric fundus, gastric body and antrum were 30 cases, gastric body, and antrum respectively in 30 cases, 12 cases (4 cases), accounting for 65.220.26.09% (8.69%) respectively, as can be seen from the data. The incidence of gastric stromal tumors (GIST) in the fundus and body of stomach was higher in 46 patients with lower risk of gastric fundus, in the middle risk group, in the high risk group, 21 cases in the high risk group, 6 cases in the high risk group, 2 cases in the low risk group, 2 cases in the middle risk group, 8 cases in the high risk group, 2 cases in the low risk group and 2 cases in the high risk group, respectively. The low risk group, middle risk group and high risk group of gastric antral lesions had 1 case or 0 cases each. According to the statistical analysis, the different growth sites of the tumor were not related to its risk grade (P0.05); according to the echo of the tumor under the ultrasound gastroscopy, the tumor had no correlation with the risk grade (P0.05). They were divided into two groups: homogeneous echo group (n = 0), heterogeneous group (n = 5), moderate risk group (n = 1), heterogeneous group (n = 8), low risk group (n = 13) and heterogeneous group (n = 19). According to statistical analysis, the more uneven the echo inside the tumor, The maximum diameter of gastric stromal tumor was 0.6-11.0 cm under ultrasound gastroscopy, the diameter of low-risk group was 0.6-3.5 cm, the average diameter was 2.00 cm, the diameter of medium-risk group was 1.5-5.5 cm, the average diameter was 3.41 cm, and the diameter of high-risk group was 5.0-11.0 cm, the average diameter was 7.22 cm. Through statistical analysis, the larger the tumor diameter, the higher the risk grade (P0.05). Conclusion: ultrasonic gastroscopy is the most important method in the diagnosis of gastric stromal tumors, and its accuracy is 64.79, which has higher diagnostic value, and the incidence of gastric stromal tumors in the fundus and body of stomach is higher than that in antrum. The risk classification of gastric stromal tumors was not related to age, sex, tumor growth site, but to the size of the lesion and internal echo.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.2
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