超声造影在神经内分泌肿瘤分化程度与肝转移的关联性中的价值

Value of Contrast-enhanced Ultrasonography in the Correlation between the Differentiation Degree of Neuroendocrine Tumor and Liver Metastasis

目的:探讨超声造影在神经内分泌肿瘤分化程度与肝转移的关联性中的应用价值。方法:回顾性选择2018年1月-2020年1月内江市第二人民医院接收的神经内分泌肿瘤肝转移患者54例,所有患者均接受超声检查,均由穿刺或者手术病理诊断确诊,均接受免疫组化染色。对所有患者超声造影表现进行分析,分别以病理Ki-67为标准分为两组(≤20%与>20%),以嗜铬素A(CgA)为标准分为两组(阴性与阳性),以G分期为标准分为两组(G1+G2期与G3期),比较各组超声造影表现的差异性。结果:动脉期增强模式中,高增强36例(66.7%),等增强9例(16.7%),环状增强6例(11.1%),低增强3例(5.6%)。门脉期呈高增强或等增强8例(14.8%),低增强46例(85.2%)。在廓清起始时间中,30 s内廓清病灶9例(16.7%);31~60 s廓清病灶27例(50.0%);61~120 s廓清病灶11例(20.4%);超过120 s廓清病灶7例(13.0%)。相较于CgA阴性组,CgA阳性组平均廓清起始时间更早,差异有统计学意义(P<0.05),其余各组间病灶大小、单发/多发、平均廓清起始时间、动脉期及门脉期增强模式比较,差异无统计学意义(P>0.05)。结论:对神经内分泌肿瘤肝转移实施超声造影,其中增强模式以高增强为主,病灶廓清时间较晚,对于分化程度之间的关联性需深入研究。

Objective:To investigate the value of contrast-enhanced ultrasonography in correlation between the differentiation degree of neuroendocrine tumor and liver metastasis.Method:A total of 54 patients with neuroendocrine tumor and liver metastasis in the Second People’s Hospital of Neijiang from January 2018 to January 2020 were retrospectively collected.All patients were examined by ultrasound examination,diagnosed by puncture or operation pathology,and all received immunohistochemical staining.The contrast-enhanced ultrasound findings of all patients were analyzed,and divided into two groups according to the Ki-67 of pathology(≤20%and>20%),then divided into two groups according to the CgA standard(negative and positive),and divided into two groups according to the G stage standard(stage G1+G2 and stage G3).The differences of contrast-enhanced ultrasound in each group were compared.Result:In arterial phase enhancement mode,36 cases(66.7%)had high enhancement,9 cases(16.7%)had equal enhancement,6 cases(11.1%)had ring enhancement,and 3 cases(5.6%)had low enhancement.In portal phase,there were 8 cases(14.8%)with high or equal enhancement and 46 cases(85.2%)with low enhancement.In the initial time of clearance,9 cases(16.7%)were cleared within 30 s,27 cases(50.0%)within 31-60 s,11 cases(20.3%)within 61-120 s and 7 cases(13.0%)beyond 120 s.Compared with CgA negative group,the mean time to start clearance of CgA positive group was earlier,and the difference was statistically significant(P<0.05).There were no significant differences in the size of lesions,single/multiple lesions,mean time to start clearance,arterial phase and portal phase enhancement mode in the other groups(P>0.05).Conclusion:Contrast-enhanced ultrasound should be used for liver metastasis of neuroendocrine tumor,in which the enhancement mode is mainly high enhancement,and the clearance time of focus is late,and the correlation between the degree of differentiation needs to be further studied.