神经内分泌肿瘤肝转移超声造影表现与分化程度的关系

Relationship between contrast-enhanced ultrasound findings and differentiation degree of liver metastases from neuroendocrine tumors

目的探讨神经内分泌肿瘤肝转移超声造影表现与分化程度的关系。方法回顾性分析我院2016年5月~2019年5月收治的140例神经内分泌肿瘤肝转移患者的临床资料,根据其分化程度,分成高分化组、中/低分化组。比较两组超声造影定量分析指标,包括峰值强度、上升时间、达峰时间、平均通过时间,分析各指标与分化程度的关系。绘制受试者工作特征曲线(ROC)分析各指标对分化程度的预测价值。结果在140例患者中,高分化53(37.86%)例,中/低分化87(62.14%)例。中/低分化组的峰值强度高于高分化组,且上升时间、达峰时间、平均通过时间较高分化组显著缩短(P<0.05)。峰值强度、上升时间、达峰时间、平均通过时间预测神经内分泌肿瘤肝转移高分化的曲线下面积(AUC)分别为0.657、0.691、0.798、0.643。结论与高分化的神经内分泌肿瘤肝转移患者相比,中/低分化患者的峰值强度增高,上升时间、达峰时间、平均通过时间明显缩短,且各指标对分化程度具有一定预测价值。

Objective To investigate the relationship between contrast-enhanced ultrasonography(CEUS)findings and differentiation of hepatic metastases from neuroendocrine tumors.Methods The clinical data of 140 patients with liver metastases from neuroendocrine tumors admitted to our hospital from May 2016 to May 2019 were retrospectively analyzed.According to the degree of differentiation,the patients were divided into highly differentiated group and moderately/poorly differentiated group.Quantitative analysis indexes of contrast-enhanced ultrasound(CEUS)were compared between the two groups,including peak intensity,rise time,peak time and average transit time,and the relationship between each index and differentiation degree was analyzed.The ROC curve was drawn to analyze the predictive value of each index to the degree of differentiation.Results Among 140 patients,53(37.86%)were highly differentiated and 87(62.14%)were moderately or poorly differentiated.The peak intensity of middle/low differentiation group was higher than that of high differentiation group,and the rising time,peak time and average transit time of high differentiation group were significantly shortened(P<0.05).The area under the curve of peak intensity,rise time,peak time and mean passage time for predicting hepatic metastasis of neuroendocrine tumors was 0.657,0.691,0.798 and 0.643 respectively.Conclusion Comparing with the patients with liver metastasis from highly differentiated neuroendocrine tumors,the peak intensity of the patients with moderately or poorly differentiated tumors increased,and the rising time,peak time and average transit time were significantly shortened,and each index had a certain predictive value for the degree of differentiation.