Kudou Michihiro, Arita Tomohiro, Nakanishi Masayoshi, Kuriu Yoshiaki, Murayama Yasutoshi, Shoda Katsutoshi, Kosuga Toshiyuki, Konishi Hirotaka, Morimura Ryo, Shiozaki Atsushi, Ikoma Hisashi, Kubota Takeshi, Fujiwara Hitoshi, Okamoto Kazuma, Otsuji Eigo
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
Anticancer Res. 2019 Jan;39(1):505-510. doi: 10.21873/anticanres.13141.
BACKGROUND/AIM: The present study aimed to clarify an accurate diagnostic method for lymph node metastasis (LN+) in rectal neuroendocrine tumors (rNETs).
This was a retrospective study of 14 rNETs and 45 rectal adenocarcinoma patients undergoing rectal resection. The short axis of LNs was measured using CT and pathological findings (43 paraffin-fixed LNs in rNETs and 786 LNs in adenocarcinoma).
The size of LN+ in CT and pathological findings was smaller in rNETs than adenocarcinoma (p=0.082 and p<0.001, respectively). The AUC values of ROC curves for detecting LN+ using LN sizes on CT were 0.837 for rNETs and 0.885 for adenocarcinoma (Cut-off values: 5 mm for rNETs, 7 mm for adenocarcinoma). rNETs were diagnosed with high accuracy using the cut-off value of rNETs (5 mm) (sensitivity: 80.0%, and specificity: 87.5%).
The size of LN+ was smaller in rNETs than in adenocarcinoma, suggesting the essentiality of diagnostic criteria specific for rNETs.
背景/目的：本研究旨在阐明一种用于直肠神经内分泌肿瘤（rNETs）淋巴结转移（LN+）的准确诊断方法。
这是一项对14例rNETs患者和45例接受直肠切除术的直肠腺癌患者的回顾性研究。使用CT测量淋巴结短轴并结合病理结果（rNETs中有43个石蜡包埋淋巴结，腺癌中有786个淋巴结）。
rNETs中CT及病理检查发现的LN+大小比腺癌小（分别为p = 0.082和p < 0.001）。利用CT上淋巴结大小检测LN+的ROC曲线AUC值，rNETs为0.837，腺癌为0.885（临界值：rNETs为5 mm，腺癌为7 mm）。采用rNETs的临界值（5 mm）对rNETs进行诊断具有较高准确性（敏感性：80.0%，特异性：87.5%）。
rNETs中LN+的大小比腺癌小，提示针对rNETs制定特异性诊断标准的必要性。
