Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Radiology, Zhejiang Prison Center Hospital (Zhejiang Youth Hospital), Hangzhou, China.
Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Eur J Radiol. 2020 Mar;124:108847. doi: 10.1016/j.ejrad.2020.108847. Epub 2020 Jan 23.
To assess the prognostic value of multidetector CT in predicting overall survival outcomes in patients with pancreatic neuroendocrine tumors (PNETs).
Seventy-one patients pathologically diagnosed with PNETs were retrospectively included. The clinical and imaging information was evaluated by two radiologists. The difference between well-differentiated and poorly differentiated PNETs was analyzed. Cox proportional hazards models were created to determine the risk factors for overall survival. Kaplan-Meier survival analyses with log-rank tests were used among different subgroups of patients with PNETs.
In the whole cohort, the median survival was 36 months, and the 5-year survival rate was 84.8 %. Patients with poorly differentiated PNETs were more likely to present with symptoms, abnormal tumor markers, larger diameters, irregular shapes, ill-defined margins, invasion into nearby tissues, liver and lymph node metastases, and lower enhancement ratio than those with well-differentiated PNETs (P < 0.05). In the multivariate analysis, lymph node metastases (hazard ratio: 21.52, P = 0.009) and a portal enhancement ratio less than 1.02 (hazard ratio: 30.89, P = 0.024) were significant factors for overall survival. Overall survival decreased with an ill-defined margin, irregular shape, poor differentiation, grade 3 disease, nonfunctional status, abnormal tumor marker levels, invasion into nearby tissues, lymph node and liver metastases, and lower enhancement ratio (log-rank P < 0.05).
Poorly differentiated PNETs were more aggressiveness than well-differentiated PNETs. Lymph node metastases and a portal enhancement ratio < 1.02 were independent prognostic factors for worse overall survival outcomes in patients with PNETs.
评估多排螺旋 CT 对预测胰腺神经内分泌肿瘤（PNETs）患者总生存结局的预后价值。
回顾性纳入 71 例经病理诊断为 PNETs 的患者。由 2 位放射科医生评估临床和影像学资料。分析分化良好和分化差的 PNETs 之间的差异。采用 Cox 比例风险模型确定总生存的危险因素。采用 Kaplan-Meier 生存分析和对数秩检验对不同 PNETs 亚组患者进行分析。
在整个队列中，中位生存时间为 36 个月，5 年生存率为 84.8%。与分化良好的 PNETs 相比，分化差的 PNETs 患者更有可能出现症状、肿瘤标志物异常、肿瘤直径较大、形态不规则、边界不清、侵犯邻近组织、肝和淋巴结转移以及增强比值较低（P<0.05）。多因素分析显示，淋巴结转移（风险比：21.52，P=0.009）和门静脉增强比值<1.02（风险比：30.89，P=0.024）是总生存的显著因素。总体生存随着边界不清、形态不规则、分化差、3 级疾病、无功能状态、肿瘤标志物水平异常、侵犯邻近组织、淋巴结和肝转移以及增强比值较低而降低（对数秩 P<0.05）。
分化差的 PNETs 比分化良好的 PNETs 更具侵袭性。淋巴结转移和门静脉增强比值<1.02 是 PNETs 患者总生存结局较差的独立预后因素。
