Choi Sang Hyun, Kim Hyoung Jung, Kim So Yeon, Byun Jae Ho, Kim Kyung Won, Song Ki Byung, Kim Song Cheol, Kim Myung-Hwan
From the Departments of *Radiology and the Research Institute of Radiology, †Surgery, and ‡Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Pancreas. 2017 Sep;46(8):1056-1063. doi: 10.1097/MPA.0000000000000888.
This study aims to identify the computed tomography (CT) features that may differentiate nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs) with lymph node (LN) metastasis from NF-PanNETs without lymph node metastasis.
We retrospectively analyzed 166 NF-PanNETs in 166 patients who had undergone surgical resection (median age, 53). Two radiologists evaluated the qualitative and quantitative CT findings. Through univariate and multivariate logistic regression analyses, we determined independent significant findings for differentiating NF-PanNETs with LN metastasis from NF-PanNETs without LN metastasis. Recurrence-free survival (RFS) and overall survival (OS) were compared between the 2 groups using Kaplan-Meier analysis and log-rank testing.
Of the 166 NF-PanNETs, 24 (14.5%) tumors demonstrated LN metastasis. Three CT findings, radiologic LN enlargement (adjusted odds ratio [OR], 11.76; P = 0.001), liver metastasis (OR, 10.31; P = 0.027), and portal enhancement ratio of <1.238 (OR, 3.58; P = 0.033), were independently significant for differentiating NF-PanNETs with LN metastasis from NF-PanNETs without LN metastasis. Tumor size greater than 2 cm also showed a statistically marginal significance (OR, 8.47; P = 0.050). The median RFS and OS in NF-PanNETs with LN metastasis were significantly shorter than NF-PanNETs without LN metastasis (23.7 months vs 33.2 months, P < 0.001; 33.7 months vs 54.8 months, P < 0.001).
Four CT findings can be useful to differentiate NF-PanNETs with LN metastasis and NF-PanNETs without LN metastasis.
本研究旨在确定计算机断层扫描（CT）特征，以区分有淋巴结（LN）转移的无功能性胰腺神经内分泌肿瘤（NF-PanNETs）和无淋巴结转移的NF-PanNETs。
我们回顾性分析了166例接受手术切除的患者（中位年龄53岁）的166例NF-PanNETs。两名放射科医生评估了定性和定量CT结果。通过单因素和多因素逻辑回归分析，我们确定了区分有LN转移的NF-PanNETs和无LN转移的NF-PanNETs的独立显著结果。使用Kaplan-Meier分析和对数秩检验比较两组的无复发生存期（RFS）和总生存期（OS）。
在166例NF-PanNETs中，24例（14.5%）肿瘤显示有LN转移。三个CT表现，即影像学上LN增大（调整优势比[OR]，11.76；P = 0.001）、肝转移（OR，10.31；P = 0.027）和门静脉强化率<1.238（OR，3.58；P = 0.033），对于区分有LN转移的NF-PanNETs和无LN转移的NF-PanNETs具有独立显著性。肿瘤大小大于2 cm也显示出统计学上的边缘显著性（OR，8.47；P = 0.050）。有LN转移的NF-PanNETs的中位RFS和OS明显短于无LN转移的NF-PanNETs（23.7个月对33.2个月，P < 0.001；33.7个月对54.8个月，P < 0.001）。
四个CT表现有助于区分有LN转移的NF-PanNETs和无LN转移的NF-PanNETs。
