Department of Radiology, Changhai Hospital, The Navy Military Medical University, 168 Changhai Rd, Shanghai 200433, China.
Department of Pathology, Changhai Hospital, The Navy Military Medical University, Shanghai, China.
AJR Am J Roentgenol. 2021 Jul;217(1):107-116. doi: 10.2214/AJR.20.23413. Epub 2021 May 12.
The purpose of the present study was to assess the consistency of measurements of pancreatic neuroendocrine tumor (PNET) tumor size obtained using pre-operative imaging, pathologic gross specimen analysis, and microscopic examination of large pathologic sections; evaluate the impact of differences in pathologic and radiologic measurements of size on T categorization; and investigate the exact relationships among tumor size measurements obtained from microscopic analysis, CT, MRI, and pathologic gross specimen analysis. We enrolled 64 patients with pathologically confirmed PNETs who underwent radiologic examination between December 2016 and September 2019. Tumor sizes were measured by CT, MRI, pathologic gross specimen analysis, and microscopic examination. The relationship between the tumor sizes calculated by MRI and microscopy was analyzed using univariate and multivariate logistic regression models. The measurements of tumor sizes calculated by pathologic and radiologic assessments and CT and MRI assessments showed good concordance, but measurements calculated by microscopic analysis and other methods showed poor concordance. When T categories from pathologic gross specimen analysis were considered the reference, alterations in T category were found in the microscopic assessments of 12 of 64 patients (18.75%), CT assessments of 15 of 64 patients (23.44%), and MRI assessments of 13 of 64 patients (20.31%). In the fully adjusted model, microscopic size (β, 1.05; 95% CI, 0.98-1.12; < .001), CT size (β, 0.90; 95% CI, 0.78-1.02; < .001), and MRI size (β, 0.92; 95% CI, 0.81-1.04; < .001) were significantly correlated with gross tumor size. Tumor sizes measured by microscopy, CT, and MRI were significantly associated with the gross size of PNETs. This finding provides physicians with new tools for rapid identification of gross tumor size.
本研究旨在评估使用术前影像学、大体病理标本分析和大病理切片的显微镜检查获得的胰腺神经内分泌肿瘤（PNET）肿瘤大小测量的一致性；评估大小的病理和影像学测量差异对 T 分类的影响；并研究从显微镜分析、CT、MRI 和大体病理标本分析获得的肿瘤大小测量之间的确切关系。我们纳入了 2016 年 12 月至 2019 年 9 月期间接受影像学检查的 64 例经病理证实的 PNET 患者。通过 CT、MRI、大体病理标本分析和显微镜检查测量肿瘤大小。使用单变量和多变量逻辑回归模型分析 MRI 和显微镜计算的肿瘤大小之间的关系。通过病理和影像学评估以及 CT 和 MRI 评估计算的肿瘤大小测量具有良好的一致性，但通过显微镜分析和其他方法计算的测量值一致性较差。当考虑大体病理标本分析的 T 分类作为参考时，在 64 例患者中的 12 例（18.75%）的显微镜评估、64 例患者中的 15 例（23.44%）的 CT 评估和 64 例患者中的 13 例（20.31%）的 MRI 评估中发现 T 分类发生了变化。在完全调整的模型中，显微镜下大小（β，1.05；95%CI，0.98-1.12；<0.001）、CT 大小（β，0.90；95%CI，0.78-1.02；<0.001）和 MRI 大小（β，0.92；95%CI，0.81-1.04；<0.001）与大体肿瘤大小显著相关。显微镜、CT 和 MRI 测量的肿瘤大小与 PNET 的大体大小显著相关。这一发现为医生提供了快速识别大体肿瘤大小的新工具。
