CT特征预测胃肠道神经内分泌肿瘤病理及预后

目的 探讨胃肠道神经内分泌肿瘤(GE-NEN)CT影像特征与病理分级及患者临床预后之间的相关性.方法 45例经病理诊断为GE-NEN的患者纳入研究,回顾性分析GE-NEN的影像征象(肿瘤体积、形态、强化方式及TNM分期)对GE-NEN良恶性诊断的准确性.并采用Kaplan-Meier方法描绘患者生存曲线,用Cox回归进行多因素分析,用Log-rank法检验GE-NEN影像特征与患者生存时间之间的关系.结果 肿瘤体积、形态、有无坏死或溃疡、T分期及N分期与其病理类型之间具有相关性(P＜0.05).GE NEN患者的生存情况与患者的年龄及病理分级相关,增强CT下肿瘤的体积、是否有囊变、坏死或溃疡及肿瘤TNM分期与患者生存之间均存在相关性,其中年龄、肿瘤是否有囊变、坏死或溃疡及远处转移是影响预后的独立因素.结论 增强CT可以用于GE-NEN的分级诊断并可预测患者的生存时间.

CT features in predicting the pathological classification and prognosis in gastroenteric neuroendocrine neoplasm

Objective To analyze the correlations between the CT features and pathological classifications of gastroentric neuroendocrineneoplasm(GE-NEN) and to evaluate the association between prognostic value and CT features.Methods 45 cases pathologically and immunohistochemically proved GE-NEN were studied retrospectively.The correlation between the CT features (tumor's volume,shape,enhancement patterns and TNM stage) and pathological classifications was analyzed.Meanwhile,the association between the CT features and patients' overall survival was evaluated by Kaplan Meier method using Log-rank test and multivariate analysis in Cox proportional hazard model.Results The CT features were proved to be associated statistically with pathological classifications including the tumor's volume,shape,with or without areas of cystic change,necrosis or ulceration,T stage and lymphadenopathy (P ＜ 0.05).On the other side,the patients' overall survivals were associated with age,pathological classifications,volume of tumors,with or without areas of cystic change,necrosis or ulceration and TNM stage.Age,areas of cystic change,necrosis or ulceration and metastases were the independent prognostic factors.Conclusion Contrast-enhanced CT can be useful in the classification of GE-NEN and predicting the patient's survival.