胃肠胰腺腺癌肝转移伴与不伴神经内分泌分化的CT鉴别

发布时间：2018-04-28 17:04

本文选题：胃肠肿瘤 + 胰腺肿瘤　；参考：《中国医学影像学杂志》2017年01期

【摘要】：目的对比伴神经内分泌分化[NED(+)]与不伴神经内分泌分化[NED(-)]胃肠胰腺腺癌肝转移的CT表现,探讨其影像学特征及在鉴别诊断中的价值。资料与方法收集2009年1月—2015年12月影像及病理资料完整的17例NED(+)的胃肠胰腺腺癌同时性肝转移患者,并于同期病例中筛选性别、年龄、原发部位匹配的34例NED(-)的单纯胃肠胰腺腺癌肝转移患者。评价两组肝转移灶数量、大小、分布、形态、增强特征,以及是否伴发腹水或淋巴结肿大。比较两组CT征象差异并判断诊断价值。结果肝动脉期两组肝转移强化区域不同,NED(+)组环周强化比例高于NED(-)组(94.1%比44.1%),差异有统计学意义(P0.05);门静脉期两组肝转移强化变化特点不同,NED(+)组流出型病灶比例高于NED(-)组(41.2%比5.9%),而NED(-)肝转移灶平台型比例高于NED(+)组(91.2%比58.8%),差异均有统计学意义(P0.05)。两组间其余CT征象差异无统计学意义(P0.05)。Logistic回归分析显示肝动脉期强化区域、门静脉期强化变化是鉴别NED(+)与NED(-)胃肠胰腺腺癌肝转移的独立影响因素(P0.05)。两征象联合判断胃肠胰腺腺癌肝转移的受试者工作特性曲线下面积为0.811(P0.05)。结论 NED(+)与NED(-)胃肠胰腺腺癌肝转移的CT强化征象具有一定的差别,对鉴别诊断具有一定的参考意义。
[Abstract]:Objective to compare the CT manifestations of [NED (+) with neuroendocrine differentiation and [NED (-)) of gastrointestinal pancreatic adenocarcinoma, and to explore its imaging features and its value in differential diagnosis. Data and methods were used to collect 17 cases of gastrointestinal pancreatic adenocarcinoma with NED (+) from January 2009 to 2015 and 12 months of pathological data. 34 cases of NED (-) simple gastrointestinal pancreatic adenocarcinoma of liver metastases were selected in the same period of cases. The number, size, distribution, morphology, enhancement characteristics of two groups of liver metastases were evaluated. The difference between the two groups of CT signs and the diagnostic value of the two groups was compared and the value of diagnosis was judged. Results liver movement NED (+) group was higher than NED (-) group (94.1% to 44.1%) in NED (+) group, and the difference was statistically significant (P0.05). The two groups of hepatic metastases in portal vein were different, the proportion of outflow lesions in NED (+) group was higher than that of NED (-) group (41.2% to 5.9%), and the proportion of NED (-) liver metastasis platform was higher than that of NED (+) group (91.2%). The difference was statistically significant (P0.05). The difference of the other CT signs between the two groups was not statistically significant (P0.05) the.Logistic regression analysis showed the enhanced area of the hepatic artery, and the enhanced changes in the portal vein were the independent factors (P0.05) to identify the NED (+) and NED (-) gastrointestinal pancreatic adenocarcinoma (P0.05). The two sign combined to judge the liver and pancreas adenocarcinoma liver. The area under the working characteristic curve of the subjects transferred was 0.811 (P0.05). Conclusion NED (+) and NED (-) CT enhanced signs of the liver metastases of gastrointestinal pancreatic adenocarcinoma were different, and had some reference significance for differential diagnosis.

【作者单位】：北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室医学影像科;北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室消化肿瘤内科;北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室病理科;
【基金】：国家自然科学基金资助项目(61520106004) 留学人员科技活动择优资助项目(京人社调发[2015]6号)
【分类号】：R735;R730.44

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