The value of multi-slice spiral CT in evaluating the malignant risks of 2-5cm gastric stromal tumors

XU Jingjing; YU Hao; ZHU Laimin; ZHAO Luping; WANG Fangfang; SUN Zhanguo; CHEN Yueqin

Abstract：Objective To explore the value of multi-slice spiral CT in evaluating the malignant risks of 2～5cm gastric stro-mal tumors.Methods The clinical,pathological and imaging data of 165 patients with 2～5cm gastric stromal tumor con-firmed by operation and pathology were selected.According to the pathological results,the patients were divided into benign bio-logical behavior group and malignant biological behavior group.The differences of clinical and CT features between the two groups were analyzed.Multivariate logistic regression analysis and receiver operating characteristic curve were used to analyze the diagnostic efficacy of independent influencing factors on tumor risk grade.Results There were statistically significant differ-ences in the risk grades of gastric stromal tumors in terms of maximum diameter,minimum diameter,growth pattern,morphol-ogy,ulcer,cystic degeneration or necrosis,tumor blood vessels,peri-tumor lymph nodes,enhancement mode,and enhance-ment degree(P<0.05).The maximum diameter,minimum diameter and tumor vessels were moderately positively correlated with the pathological risk grade,and the AUC of the maximum diameter of the tumor was the largest(0.894).The specificity and ac-curacy were the highest,which were 87.8%and 87.3%,respectively.Logistic regression analysis showed that the maximum di-ameter of gastric stromal tumor(OR=7.560,P<0.001),growth pattern(OR=2.747,P=0.002)and tumor vessel(OR=5.817,P=0.001)were independent influencing factors to distinguish different risk grades of GST.When the maximum diameter of the tu-mor,the growth mode and the combination of tumor vessels,the AUC was 0.936,the diagnostic efficiency was higher than that of the single model(Z=2.016～5.770,P=0.001～0.044);the sensitivity was 83.3%,the specificity was 91.8%,and the accuracy was 89.6%,all of which were higher than the single model.Conclusion Multi-slice spiral CT has important diagnostic value in the malignancy risk staging of 2-5cm gastric stromal tumors.Combined with tumor maximum diameter,growth pattern and tu-mor vessels,the malignant risks can be better evaluated,which is of great significance for preoperative evaluation and choice of treatment.