胰腺神经内分泌肿瘤影像学特征与病理分级的关系  

Pancreatic neuroendocrine neoplasms: correlation of imaging feature with pathologic grading

作　　者：徐学勤[1] 缪飞[1] 林晓珠[1] 张静[1] 吴志远[1] 郭滟[2] 陈克敏[1] 严福华[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025 [2]上海交通大学医学院附属瑞金医院病理科,上海200025

出　　处：《诊断学理论与实践》2014年第5期481-486,共6页Journal of Diagnostics Concepts & Practice

基　　金：国家自然科学基金青年项目(81201145);国家临床重点专科建设项目;上海高校一流学科(B)类建设项目

摘　　要：目的 :评价相关影像学特征在鉴别低级与非低级胰腺神经内分泌肿瘤(pancreatic neuroendocrine neoplasms,p NENs)中的价值。方法 :回顾性分析54例经病理证实的p NENs患者的CT特征,其中低级p NENs组40例,病理分级均为1级;非低级p NENs组14例,病理分级为2级者11例,3级者3例。结果:2组间的性别、钙化、不均质、侵袭性、主胰管扩张、淋巴结增大、病灶最大径差异存在统计学意义(P<0.05)。非低级p NENs的平均最大径大于低级p NENs,病灶最大径鉴别两者的受试者工作特征(ROC)曲线下面积(area under curve,AUC)为0.843。当病灶最大径界值为2.6 cm时,鉴别非低级与低级p NENs的灵敏度和特异度分别为78.6%和87.5%。Logistic回归方程鉴别2组的AUC为0.913,准确率为85.2%。Logistic回归方程的AUC与病灶最大径值的AUC间差异无统计学意义(P=0.070)。结论 :非低级p NENs在影像学上与低级p NENs间存在差异,其中病灶最大径是鉴别两者的最佳单一指标。Objective： To investigate the value of imaging characteristics on differentiating non-low grade（non-LG）pancreatic neuroendocrine neoplasms（p NENs） from low grade（LG） p NENs. Methods： CT imaging data from 54 pathologically proven p NENs were retrospectively analyzed. Patients were divided into two groups： 40 cases in LG p NENs group had grade 1 and 14 cases in non-LG p NENs group had 11 grade 2 and 3 grade 3. Results： Significant differences in gender, calcification, inhomogeneity, invasiveness, pancreatic duct dilatation, lymph node enlargement, and size were found between non-LG p NENs and LG p NENs groups（P〈0.05）. Non-LG p NENs had larger size than LG p NENs. The tumor size had good diagnostic performance, with area under ROC curve（AUC） of 0.843. When a cutoff value for tumor size was set as 2.6 cm, diagnostic sensitivity was 78.6% and specificity was 87.5% in differentiating non-LG p NENs from LG p NENs.Multivariate analysis with logistic regression had AUC of 0.913 and accuracy of 85.2% in differentiating non-LG p NENs from LG p NENs. There was no significant difference between the AUC of tumor size and logistic regression（P =0.070）.Conclusions： There are significant differences in imaging features between non-LG and LG p NENs. Tumor size is the most promising independent parameter in differentiating non-LG p NENs from LG p NENs.

关 键 词：胰腺神经内分泌肿瘤 分级 影像学特征 

分 类 号：R735.9[医药卫生—肿瘤]