Yang Cai-Wei, Liu Xi-Jiao, Zhao Lian, Che Feng, Yin Yuan, Chen Hui-Jiao, Zhang Bo, Wu Min, Song Bin
West China School of Medicine, Sichuan University, Chengdu, China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
Ann Transl Med. 2021 Oct;9(20):1556. doi: 10.21037/atm-21-4669.
To determine whether preoperative computed tomography (CT) features can be used for the prediction of gastrointestinal stromal tumors (GISTs) with a high Ki-67 proliferation index (Ki-67 PI).
A total of 198 patients with surgically and pathologically proven GISTs were retrospectively included. All GISTs were divided into a low Ki-67 PI group (<10%) and a high Ki-67 PI group (≥10%). All imaging features were blindly interpreted by two radiologists. Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the predictive performance of the imaging features.
Imaging features were found to be significantly different between the low and the high Ki-67 PI groups (P<0.05). Wall thickness of necrosis showed the highest predictive ability, with an area under the curve (AUC) of 0.838 [95% confidence interval (CI): 0.627-0.957], followed by necrosis, necrosis degree, hyperenhancement of the overlying mucosa (HYOM), and long diameter (LD) (AUC >0.7, P<0.05). HYOM was the strongest predictive feature for the high Ki-67 PI GISTs group, with an odds ratio (OR) value of 30.037 (95% CI: 5.707-158.106).
Imaging features, including the presence of necrosis, high necrosis degree, thick wall of necrosis, and HYOM were significant predictive indicators for the high Ki-67 PI GISTs group.
确定术前计算机断层扫描（CT）特征是否可用于预测具有高Ki-67增殖指数（Ki-67 PI）的胃肠道间质瘤（GIST）。
回顾性纳入198例经手术和病理证实的GIST患者。所有GIST分为低Ki-67 PI组（<10%）和高Ki-67 PI组（≥10%）。所有影像特征由两名放射科医生进行盲法解读。采用受试者操作特征（ROC）曲线分析评估影像特征的预测性能。
低Ki-67 PI组和高Ki-67 PI组的影像特征存在显著差异（P<0.05）。坏死壁厚度的预测能力最强，曲线下面积（AUC）为0.838 [95%置信区间（CI）：0.627-0.957]，其次为坏死、坏死程度、覆盖黏膜的强化（HYOM）和长径（LD）（AUC>0.7，P<0.05）。HYOM是高Ki-67 PI GISTs组最强的预测特征，优势比（OR）值为30.037（95% CI：5.707-158.106）。
影像特征，包括坏死的存在、高坏死程度、坏死壁增厚和HYOM是高Ki-67 PI GISTs组的重要预测指标。
