囊实性胰腺神经内分泌肿瘤CT 和病理对照及与 Ki-67表达的相关性

目的：探讨囊实性胰腺神经内分泌肿瘤(CPNETs)的 CT 和病理特征与 Ki-67表达的相关性。方法回顾性分析19例经手术病理证实为 CPNETs 患者的资料,标本应用免疫组化检测19例肿瘤标本的 Ki-67表达,分析 CT 表现与 Ki-67之间的关系。结果19例患者共检出20个病灶,18例为单发病灶,1例为十二指肠、胰腺各1个病灶。肿块直径1.8~10.0 cm 不等。高分化CPNETs(Ki-67<3%)6例；中等分化 CPNETs(Ki-67为3%~20%)8例；低分化 CPNETs(Ki-67>20%)5例。肿瘤 Ki-67表达水平与患者的年龄、性别、发生部位无明显相关性(P >0.05)。Ki-67的表达与肿瘤的直径、对周围血管的累及、胰管扩张、肿大淋巴结及远隔转移呈正相关(P <0.05)。随 Ki-67表达增高肿瘤趋向不规整分叶状形态,同时肿瘤囊壁趋向不规则、壁结节多见(P <0.01)。Ki-67的表达与肿瘤的囊性比例呈负相关(P <0.05)。Ki-67的表达与肿瘤的血供无相关性(P >0.05)。结论CPNETs 的部分CT 特征和 Ki-67的表达相关,这些特征有助于间接反映 CPNETs 的分级及预后。

Correlations of CT features,pathological findings and expression of Ki-67 in cystic-solid pancreatic neuroendocrine tumors

Objective To study the correlations between CT,pathology features and expression of Ki-67 in cystic-solid pancreatic neuroendocrine tumors(CPNETs).Methods CT images of 19 cases with pathologically proved CPNETs were retrospectively analyzed.Ki-67 expression were determined by immunohistochemical method in all patients.The correlation between expression of Ki-67 and CT features in CPNETs were studied.Results Of the 1 9 cases,20 lesions were revealed including 18 cases with single lesion and one case with two lesions in the duodenum and pancreatic head.The diameters of the masses ranged from 1.8 cm to 10.0 cm.The lesions were divided into 3 groups according to the expressions of tumor Ki-67,inclduing well differentiated CPNETs (Ki-67<3%,6 cases);median differentiated CPNETs(Ki-67 was 3% ~20%,8 cases)and low differentiated CPNETs(Ki-67 > 20%,5 cases).The expressions of tumor Ki-67 were not correlated with patient’s age,sex and occurring place(P >0.05).There were positive correlation between Ki-67 and tumor diameter,dilatation of pancreatic duct,vessels invasion,lymph lode metastasis and distant metastasis(P<0.05).With the increased expression of Ki-67 tumor tends to be irregular lobulated shape,meanwhile the cystic wall tends to be more irregular and the wall nodule could be seen (P<0.01).Negative correlation were observed between Ki-67 and the cystic proportion of tumor(P<0.05).The expressions of tumor Ki-67 were not correlated with the blood supply(P >0.05).Conclusion Some CT features of CPNETs are associated with the expression of Ki-67,which would be helpful in staging and making prognosis for CPNETs.