Tamura Takashi, Sugihara Yuto, Yamazaki Hirofumi, Koutani Hiromu, Tamura Takaaki, Tsuda Ikuhisa, Emori Tomoya, Kawaji Yuki, Hatamaru Keiichi, Yamashita Yasunobu, Itonaga Masahiro, Ashida Reiko, Kitano Masayuki
Second Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan.
Diagnostics (Basel). 2022 Nov 29;12(12):2988. doi: 10.3390/diagnostics12122988.
The purpose of this study is to clarify the associations between the enhancement patterns on contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) and the aggressiveness and prognosis of pancreatic neuroendocrine neoplasms (PanNENs). Patients who underwent CH-EUS and were pathologically diagnosed with PanNEN were included in this study. Patients were divided into three groups according to contrast-enhancement patterns on early-phase and late-phase imaging: “Group A”, vascular rich in both phases; “Group B”, vascular rich and vascular poor in early and late phases, respectively; “Group C”, vascular poor in both phases. Of 39 patients, 25 were assigned to Group A, 7 to Group B, and 7 to Group C. The median overall survival was not reached in Groups A and B and was 335 days in Group C (p < 0.001). The 1-year survival rates were 100% in Group A, 60% in Group B, and 43% in Group C. Patients in Group C showed the shortest overall survival among the three groups. The vascular-poor pattern on late-phase CH-EUS had the highest sensitivity, specificity, and accuracy for aggressive PanNENs among the patterns analyzed on CH-EUS and CECT (84.6%, 91.7%, and 89.2%, respectively). CH-EUS is useful for the diagnosis of and predicting the prognosis of PanNENs.
本研究的目的是阐明对比增强谐波内镜超声（CH-EUS）上的增强模式与胰腺神经内分泌肿瘤（PanNENs）的侵袭性和预后之间的关联。本研究纳入了接受CH-EUS检查并经病理诊断为PanNEN的患者。根据早期和晚期成像的对比增强模式，将患者分为三组：“A组”，两期均血管丰富；“B组”，早期血管丰富，晚期血管缺乏；“C组”，两期均血管缺乏。39例患者中，25例被分配到A组，7例到B组，7例到C组。A组和B组的中位总生存期未达到，C组为335天（p<0.001）。A组的1年生存率为100%，B组为60%，C组为43%。C组患者的总生存期在三组中最短。在CH-EUS和CT上分析的模式中，晚期CH-EUS上的血管缺乏模式对侵袭性PanNENs具有最高的敏感性、特异性和准确性（分别为84.6%、91.7%和89.2%）。CH-EUS对PanNENs的诊断和预后预测有用。
