CT预估老年胃肠道神经内分泌肿瘤病理分级的可行性研究

The Feasibility Study on CT Features in Predicting the Pathological Grading of GI-NENs in the Elderly

目的探讨CT特征在预测老年人胃肠道神经内分泌肿瘤(GI-NENs)病理分级的价值。方法回顾性分析经手术病理证实为GI-NENs,且临床、影像及病理资料完整的34例患者。分析肿瘤的CT表现,包括肿瘤部位、长径、生长方式、边缘、密度、强化特点、坏死或溃疡、邻近脏器侵犯及淋巴结转移、远处转移等。参照WHO 2010版消化系统肿瘤分级系统标准,将肿瘤的病理分级分为G1、G2、G3级。3组间定量指标采用单因素方差分析,定性指标采用卡方检验。年龄与其它因素的相关性分析采用单因素方差分析及独立样本t检验。结果 G1、G2与G3这3组肿瘤发病年龄、部位、长径、坏死或溃疡、淋巴结转移差异有统计学意义(P<0.05),生长方式、边缘、强化程度及均匀度、邻近组织侵犯及远处转移间差异无统计学意义(P>0.05)。年龄和发病部位间差异有统计学意义(P<0.05)。结论 CT检查预估GI-NEN的病理分级是可行的,可作为治疗的分级依据。

Objective To investigate the value of CT features in predicting the pathological grading of gastrointestinal neuroendocrine neoplasms （GI-NENs） in the elderly. Methods A retrospective analysis was made clinical, imaging and pathological data of 34 elderly with GI-NEN confirmed by surgery and pathological study. CT imaging analysis included tumor location, long diameter, growth pattern, lesion margins, density, enhancement patterns, necrosis or ulceration, transmural invasion, adjacent organ invasion and metastases of lymph mode and distant organs; histopathological grade of GI-NENs was defined as G1 （group G1）, G2 （group G2） and G3 （group G3） according to World Health Organization classification of tumours of the digestive system guidelines （2010）; one-way ANOVA was made to the quantitative indexes in the 3 groups while Chi-square test to qualitative indexes; the correlation between age and other factors was analyzed by one-way ANOVA and independent t-test. Results There existed statistical differences in tumor location, long diameter, necrosis or ulceration and lymphadenopathy among the 3 groups （P〈0.05） while no statistical differences in growth pattern, lesion margins, density, enhancement patterns, adjacent tissue infiltration and distant organ metastasis among the 3 groups （P〉0.05）; the differences in age and tumor lesion among the 3 groups were of statistical significance （P〈0.05）. Conclusions CT features is feasible in predicating the pathological grading of GI-NENs, which can be taken as grading basis in the treatment.