胃肠胰神经内分泌癌与伴神经内分泌分化腺癌肝转移CT影像鉴别

发布时间：2018-05-06 14:24

本文选题：神经内分泌癌 + 腺癌　；参考：《临床放射学杂志》2017年10期

【摘要】：目的探讨动态增强CT征象在鉴别胃肠胰神经内分泌癌(GEP-NECs)与伴神经内分泌分化(NED)腺癌(GEP-ADCs)肝转移的可行性。方法回顾性分析经手术或活检病理证实的GEP-NECs肝转移患者49例及NED(+)的GEP-ADCs肝转移患者17例。对比肝转移灶动态增强CT影像学征象。结果 GEP-NECs与NED(+)的GEP-ADCs肝转移两组比较,病灶分布、数量、大小、形态、动态增强类型、肝动脉期强化范围、伴发腹腔积液及淋巴结肿大出现比例两组差异无统计学意义(P值均0.05)。在GEP-NECs中肝动脉期瘤周灌注增高出现比例高于NED(+)的GEP-ADCs组(34.7%比11.8%),虽然两组比较未达到统计学意义(P=0.137),但Logistic回归分析显示其是判断GEP-ADCs的独立预测因素(P=0.048),ROC分析其判断GEP-ADCs的曲线下面积为0.705。结论GEP-NECs与NED(+)GEP-ADCs的CT征象中,肝动脉期瘤周灌注增高具有潜在鉴别诊断价值。
[Abstract]:Objective to investigate the feasibility of dynamic contrast enhanced CT in differentiating GEP-NECs from neoplastic neoplasms (GEP-NECs) and adenocarcinoma (GEP-ADCs) with neuroendocrine differentiation (NED). Methods 49 patients with GEP-NECs liver metastasis and 17 patients with NED (NED ()) liver metastasis with GEP-ADCs were retrospectively analyzed. Dynamic contrast-enhanced CT findings of hepatic metastases were compared. Results there was no significant difference in the distribution, number, size, morphology, type of dynamic enhancement, enhancement range of hepatic artery phase, the proportion of abdominal effusion and lymph node enlargement between GEP-NECs and NED (n = 2) groups (P = 0.05). The proportion of hepatic arterial perinumoral perfusion increased in GEP-NECs group (34.7%) was higher than that in NED () group (11.8%). Although the comparison between the two groups was not statistically significant, Logistic regression analysis showed that it was an independent predictor of GEP-ADCs. The area under the curve of GEP-ADCs was 0.705. Conclusion among CT signs of GEP-NECs and NED, the increase of hepatic arterial peri-aneurysm perfusion is of potential value in 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(编号:61520106004) 留学人员科技活动择优资助项目
【分类号】：R730.44;R735

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