Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, Kyoto, Japan.
Department of Surgery, Shiga General Hospital, Moriyama, Japan.
J Hepatobiliary Pancreat Sci. 2020 Jul;27(7):414-420. doi: 10.1002/jhbp.734. Epub 2020 May 14.
Although F-FDG-PET/CT is a widely used diagnostic tool for several malignancies, its efficacy in diagnosing pancreatic neuroendocrine tumors is reported to be controversial because of the short-term follow-up.
We retrospectively compared demographics and pathological features between F-FDG-positive and -negative diseases. Additionally, we evaluated whether the avidity of F-FDG-PET/CT affected earlier recurrence after curative treatment of non-functioning tumors. The median duration of observation was 65.6 months.
Seventy-two patients were enrolled. F-FDG-positive diseases were pathologically advanced and significantly associated with metastatic behavior. In a multivariate analysis, metastatic behavior and WHO tumor grade was independently associated with F-FDG accumulation. Only 25% of functional tumors (4/16) and 8% of insulinomas (1/12) were F-FDG-positive. In a Kaplan-Meier analysis in patients with non-functioning tumors (n = 56), F-FDG-positivity was significantly correlated with poorer recurrence-free survival (RFS) but had no correlation with overall survival. In univariate analysis of factors associated with shorter RFS, male gender, prevalence of nodal metastasis, WHO tumor grade ≥G2, or F-FDG-positive disease were significantly higher in patients with shorter RFS, whereas only F-FDG-positivity was associated with shorter RFS in multivariate analyses.
The avidity of F-FDG-PET/CT was associated with metastatic behavior of pancreatic neuroendocrine tumors and recurrence after treatment of non-functioning tumors.
虽然 F-FDG-PET/CT 是多种恶性肿瘤广泛使用的诊断工具，但由于短期随访，其在诊断胰腺神经内分泌肿瘤方面的疗效存在争议。
我们回顾性比较了 F-FDG 阳性和阴性疾病的人口统计学和病理特征。此外，我们评估了 F-FDG-PET/CT 的摄取是否会影响无功能性肿瘤根治性治疗后的早期复发。中位观察时间为 65.6 个月。
共纳入 72 例患者。F-FDG 阳性疾病的病理进展明显，并与转移行为显著相关。多变量分析显示，转移行为和 WHO 肿瘤分级与 F-FDG 摄取独立相关。仅有 25%的功能性肿瘤（4/16）和 8%的胰岛素瘤（1/12）为 F-FDG 阳性。在无功能性肿瘤患者（n=56）的 Kaplan-Meier 分析中，F-FDG 阳性与无复发生存率（RFS）较差显著相关，但与总生存率无相关性。在与 RFS 较短相关的因素的单因素分析中，男性、淋巴结转移的发生率、WHO 肿瘤分级≥G2 或 F-FDG 阳性疾病在 RFS 较短的患者中显著更高，而仅 F-FDG 阳性与多因素分析中的 RFS 较短相关。
F-FDG-PET/CT 的摄取与胰腺神经内分泌肿瘤的转移行为以及无功能性肿瘤治疗后的复发有关。
