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目的:探索高风险胃间质瘤的术前预测评分系统。方法:回顾性分析2008—2018年在西京医院行内镜或外科切除治疗的275例直径≤5 cm的胃间质瘤患者资料，经多因素分析找出高风险胃间质瘤的独立危险因素，并根据其回归系数对独立危险因素进行赋分，建立术前预测评分。以评分系统为检验变量，绘制受试者工作特征(receiver operator characteristic, ROC)曲线，计算曲线下面积(area under curve，AUC)。结果:肿瘤直径>1.75 cm(n OR＝6.474，95%n CI：2.335～17.948)、肿瘤不规则形态(n OR＝3.548，95%n CI：1.745～7.216)和溃疡(n OR＝2.412，95%n CI：1.154～5.041)是预测直径≤5 cm高风险胃间质瘤的独立危险因素(n P均1.75 cm为3分。评分系统的AUC值为0.781，最佳截断值为4；将评分0～3分定义为低危组，4～6分定义为高危组，低危组的高风险胃间质瘤发生率为13.3%(26/196)，高危组的高风险胃间质瘤发生率为48.1%(38/79)，差异有统计学意义(n χ2＝38.266，n P1.75 cm、肿瘤呈不规则形态和溃疡，这3个因素构建的术前评分系统具有较好的高风险个体预测能力。“,”Objective:To explore a scoring system of preoperative evaluation for high-risk gastric stromal tumors.Methods:A total of 275 consecutive patients with gastric stromal tumors of diameter ≤5 cm who underwent surgical or endoscopic resection at Xijing Hospital between 2008 and 2018 were retrospectively enrolled in the study. Multivariate logistic regression analysis was performed to investigate independent risk factors for high-risk gastric stromal tumors.Weighted points was proportionally assigned based on β regression coefficient value to establish the scoring system. The receiver operator characteristic (ROC) curve was plotted, the scoring system as the test variable, and the area under curve (AUC) was calculated.Results:Multivariate analysis revealed tumor size>1.75 cm (n OR=6.474, 95%n CI: 2.335-17.948), irregular tumor shape (n OR=3.548, 95%n CI: 1.745-7.216) and mucosal ulceration (n OR=2.412, 95%n CI: 1.154-5.041) were independent risk factors for high-risk gastric stromal tumors of diameter ≤5 cm (n P1.75 cm. The AUC value of the scoring system was 0.781, of which the cut-off value was 4. According to the cut-off value, 0-3 points was categorized as the low risk group and 4-6 points as the high risk group for gastric stromal tumors. The incidence of high-risk gastric stromal tumors of the low risk group and the high risk group were 13.3% (26/196) and 48.1% (38/79), respectively, with significant difference (n χ2=38.266, n P<0.001).n Conclusion:Tumor size larger than 1.75 cm, irregular tumor shape and mucosal ulceration can be applied to establish a preoperative scoring system to predict high-risk gastric stromal tumors of diameter ≤5 cm.