食管神经内分泌肿瘤的临床影像表现分析

Clinical and imaging analysis of esophageal neuroendocrine tumor

目的:探讨食管神经内分泌肿瘤患者的临床、影像、病理特征,以提高对该病的认识及诊治水平。方法:回顾性收集并分析2013年1月—2023年2月郑州大学第一附属医院54例经病理确诊的食管神经内分泌肿瘤患者的临床、病理及CT影像资料,观察并评估病灶的部位、TNM分期、病变厚度、长度、长径与食管长轴关系、浸润范围、瘤周界面、病变均质性、强化程度、增强模式等。结果:53例神经内分泌癌患者首发症状以进食哽噎感及吞咽困难最常见,化疗和/或免疫治疗为最常用的治疗方案,淋巴结及远处转移率分别为79.63%、29.63%。位于食管中下段者占92.59%,平均病变厚度为14.91 mm,平均病变长度为42.92 mm。病变均与食管长轴平行,浸润范围≥180°者占68%,瘤周界面规则者占66%,均质者占54%,强化程度中度以上、持续性强化分别占74%、77%,Ki-67平均指数为79.25%。CD56、Syn、CK、CgA、EMA表达阳性率分别为96.23%、94.34%、90.57%、49.05%、22.64%,多项指标联合诊断效能更高。结论:食管神经内分泌癌少见,影像学表现对于定位及分期诊断具有一定价值,未发现CT特征与临床病理因素之间存在相关性,影像学表现联合临床病理资料可提高对该病的诊治水平。

Objective:To investigate the clinical,imaging and pathological characteristics of patients with esophageal neuroendocrine tumor,so as to improve the understanding,diagnosis and treatment of this disease.Methods:The clinical,pathological and CT imaging data of 54 patients with neuroendocrine tumor diagnosed by pathology in the First Affiliated Hospital of Zhengzhou University from January 2013 to February 2023 were retrospectively collected and analyzed,and the location,TNM stage,thickness,length of the lesion,relationship between the length and esophageal long axis,invasion range,peritumor interface,lesion homogeneity,degree of enhancement,enhancement mode,etc.were observed and evaluated.Results:Among53 cases of neuroendocrine carcinoma,the first symptoms of most of the patients were choking while eating and dysphagia,and chemotherapy and/or immunotherapy became the most commonly used treatment options,with lymph node and distant metastasis rates of 79.63%and 29.63%,respectively.92.59%of cases were located in the middle and lower esophagus,with an average lesion thickness of 14.91 mm and an average lesion length of 42.92 mm.The lesions were all parallel to the long axis of the esophagus,with an invasion range≥180°accounting for 68%,a regular peritumor interface accounting for 66%,and a homogeneous lesions accounting for 54%.Moderate or above enhancement and sustained enhancement accounted for74%and 77%,respectively.The average index of Ki-67 was 79.25%,and the positive rates of CD56,Syn,CK,CgA and EMA expression were 96.23%,94.34%,90.57%,49.05%and 22.64%,respectively,and the combined diagnosis efficiency of multiple indicators was higher.Conclusion:Esophageal neuroendocrine carcinoma is rare,and imaging findings have certain value for localization and staging diagnosis,no correlation between clinicopathologic factors was found,and imaging manifesta-tions combined with clinicopathological data can improve the diagnosis and treatment of this disease.