摘要
目的:探讨增强CT在预测胃肠道神经内分泌肿瘤淋巴结转移中的价值.方法:回顾性分析33 例经手术病理证实的胃肠道神经内分泌肿瘤的增强CT表现,比较淋巴结转移组与非淋巴结转移组的定性差异及测量其相关CT值的定量差异,并对其进行χ2检验、Fisher精确性检验、Mann-Whitney U检验及 Logistic回归分析.结果:两组在肿瘤坏死、内壁侵犯、外壁侵犯、强化均匀度、分层强化、淋巴结肿大及远处转移间比较,差异均无统计学意义(均P>0.05).两组在静脉期最大CT值(VPmax)(P=0.035)、静脉期平均CT值(VPmean)(P=0.043)、静脉期平均CT值-平扫期CT值(VPmean-NP)(P=0.015)、静脉期平均CT值-平扫期CT值除以平扫期CT值(VPmean-NP/NP)(P=0.011)差异有统计学意义.ROC曲线分析显示,VPmax、VPmean、VPmean-NP、VPmean-NP/NP曲线下面积(AUC)值分别为0.741、0.731、0.778、0.792,VPmean-NP/NP诊断效能最好.结论:增强CT部分参数在预测胃肠道神经内分泌肿瘤淋巴结转移上具有一定价值.
Abstract
Objective:To investigate the value of contrast-enhanced(CE)computed tomography(CT)in predicting lymph node metastasis(LNM)of gastrointestinal neuroendocrine tumors(GINTs).Methods:The CECT manifestations of 33 cases with GINTs confirmed by postoperative pathology were retrospectively analyzed.The qualitative differences and quantitative differences between the groups with and without LNM were compared.The chi-square test,Fisher's exact test,Mann-Whitney U test and Logistic regression analysis were performed.Results:There were no statistically significant differences in the necrosis of GINTs,the invasion of the inner and outer walls,the uniformity of enhancement,stratified enhancement,lymphadenectasis,and distant metastasis between the groups.The CT parameters of VPmax(P=0.035),VPmean(P=0.043),VPmea-NP(P=0.015),and VPmean-NP/NP(P=0.011)were significantly different between the two groups.According to receiver operating characteristic(ROC)curve analysis,the areas under the ROC curves of CT parameters of VPmax,VPmean,VPmean-NP,and VPmean-NP/NP were 0.741,0.731,0.778 and 0.792,respectively.The diagnostic efficiency of VPmean-NP/NP was the best.Conclusion:CECT has certain value in predicting LNM of GINTs.
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