CAJ | 학술논문

目的：探讨超声评估小肠间质瘤恶性风险的价值。方法回顾性分析经手术病理和免疫组化证实的55例小肠间质瘤患者的声像图表现，依据胃肠道间质瘤（gastrointestinal stromal tumor，GIST）病理危险度分级将其分为低危组、中危组、高危组；声像图分析包括肿瘤的大小、形态、边界、内部回声，并对各组的上述征象进行方差分析或Fisher精确检验。结果55例小肠间质瘤中，低危组患者有8例，中危组患者有3例，高危组患者有44例。病灶最大径为3.5～28.0 cm；低危组病灶平均大小为4.3 cm，中危组为7.2 cm，高危组为11.2 cm。与低危组患者中出现回声不均、分叶、囊变的比例（25.0%、37.5%、25.0%）相比，中危组和高危组的比例高，分别为100.0%、100.0%、66.7%和88.6%、86.4%、81.8%；肿瘤大小、回声均质性、分叶、囊变在不同组间的差异有显著的统计学意义（均P＜0.05）。不同危险度分组中，肿瘤内有气体回声的比例在中危组（1/3，33.3%）和高危组（8/44，18.2%）中均高于低危组（0/8，0）；血流丰富的比例在高危组（17/44，38.6%）中的比例高于低危组（0/8，0）和中危组（1/8，12.5%），但无统计学意义（P＞0.05）。结论超声对评估小肠间质瘤恶性风险有一定价值。
목적：탐토초성평고소장간질류악성풍험적개치。방법회고성분석경수술병리화면역조화증실적55례소장간질류환자적성상도표현，의거위장도간질류（gastrointestinal stromal tumor，GIST）병리위험도분급장기분위저위조、중위조、고위조；성상도분석포괄종류적대소、형태、변계、내부회성，병대각조적상술정상진행방차분석혹Fisher정학검험。결과55례소장간질류중，저위조환자유8례，중위조환자유3례，고위조환자유44례。병조최대경위3.5～28.0 cm；저위조병조평균대소위4.3 cm，중위조위7.2 cm，고위조위11.2 cm。여저위조환자중출현회성불균、분협、낭변적비례（25.0%、37.5%、25.0%）상비，중위조화고위조적비례고，분별위100.0%、100.0%、66.7%화88.6%、86.4%、81.8%；종류대소、회성균질성、분협、낭변재불동조간적차이유현저적통계학의의（균P＜0.05）。불동위험도분조중，종류내유기체회성적비례재중위조（1/3，33.3%）화고위조（8/44，18.2%）중균고우저위조（0/8，0）；혈류봉부적비례재고위조（17/44，38.6%）중적비례고우저위조（0/8，0）화중위조（1/8，12.5%），단무통계학의의（P＞0.05）。결론초성대평고소장간질류악성풍험유일정개치。
Objective To investigate the value of ultrasonography (US) in estimating the risk of malignancy in small intestinal stromal tumors. Method The US features were evaluated retrospectively in 55 patients with patholog-ically and immunohistochemically confirmed small intestinal stromal tumors, who were divided into high-risk (n =44), moderate-risk (n = 3), and low-risk (n = 8) of malignancy groups based on mitotic activity, location and size of the tumors. The US features included tumor size, lobulation, heterogeneity, cystic change, hyperechoic foci, calcifica-tion and color Doppler flow. The correlation of US features with the risk of malignancy was evaluated using either Fisher ’s exact test or ANOVA. Result The maximum diameter of the tumors was 3.5 - 28.0 cm, and the mean di-ameters of tumors were 4.3 cm, 7.2 cm, 11.2 cm in low-, moderate-, and high-risk groups, respectively. The propor-tions of heterogeneity, lobulation, cystic change in low-risk group were less than that of moderate- and high-risk group (25% vs 100.0% vs 88.6%, 37.5% vs 100.0% vs 86.4%, and 25.0% vs 66.7% vs 81.8%), indicating a correla-tion with the risk of malignancy (P < 0.05). Tumor size, heterogeneity, lobulation and cystic changes differed signifi-cantly among groups (P < 0.05). Hyperechoic foci appeared more in moderate- (1/3, 33.3%) and high-risk group (8/44, 18.2%) than in low-risk group (0/8, 0); and abundant color signals were more frequent in high-risk group (17/44, 38.6%) than in intermediate-risk group (1/8, 12.5%) and low-risk group (0/8, 0), but without significant difference. Conclusion Certain US features are associated with increased risk of malignancy in small intestinal stromal tumors.