CT鉴别诊断胃神经内分泌癌与胃腺癌

CT differential diagnosis of gastric neuroendocrine carcinoma and gastric adenocarcinoma

目的观察CT鉴别诊断胃神经内分泌癌(GNEC)与胃腺癌(GC)的效能。方法回顾性分析经病理确诊的62例GNEC(GNEC组)和70例GC(GC组)患者,手术或活检前7天内均接受腹部增强CT检查,对比组间临床资料及CT特征。针对差异有统计学意义的CT特征进行Logistic回归分析,并绘制受试者工作特征(ROC)曲线,分析CT特征对鉴别GNEC与GC的效能。结果组间肿瘤边界、囊变/坏死和肝转移以及肿瘤厚径、静脉-动脉期强化率差异均有统计学意义(P均<0.05)。肿瘤边界、厚径、囊变/坏死、肝转移及强化特点可作为独立预测因素鉴别GNEC与GC(P均<0.05)。ROC曲线结果显示,以上述参数单独鉴别GNEC与GC的曲线下面积(AUC)分别为0.63、0.69、0.65、0.62、0.63,各参数联合鉴别诊断的AUC可达0.83。结论CT特征可用于鉴别GNEC与GC。

Objective To investigate the value of CT in differentiating gastric neuroendocrine carcinoma(GNEC)from gastric adenocarcinoma(GC).Methods Data of 62 patients with GNEC(GNEC group)and 70 with GC(GC group)confirmed by pathology who underwent enhanced CT scanning within 7 days before surgical operation or biopsy were retrospectively analyzed.CT features and clinical manifestations were compared between 2 groups.The Logistic regression analysis was performed for CT features being statistically different between 2 groups to analyze the independent predictors for distinguishing GNEC from GC,and the differential diagnostic efficiency was assessed using receiver operating characteristic(ROC)curve.Results There were significant differences of tumor boundary,cystic/necrosis and hepatic metastasis,also thickness diameter and venous-arterial phase enhancement rate of tumor between 2 groups(all P<0.05).The boundary,thickness diameter,cystic/necrosis,hepatic metastasis and venous-arterial phase enhancement rate of tumor could be used as independent predictors for differentiating GNEC from GC(P<0.05),with the area under curve(AUC)of 0.63,0.69,0.65,0.62 and 0.63,respectively,while the AUC of combination of all the above features was 0.83.Conclusion CT features could be used to distinguish GNEC from GC.