Correlation Analysis Of Clinical Pathological Features And Computed Tomography Features In Pancreatic Neuroendocrine Neoplasms(pNENs)

Objective1.Analysis the clinical pathological features of pancreatic neuroendocrine tumors(p NENs)in different levels.2.Explore the correlation of preoperative CT features and pathologic grades in p NENs.Further analysis the diagnosis value of preoperative CT values in different pathological grading of p NENs.Methods1.266 cases who were diagnosed p NENs in Shanghai changhai hospital and Shanghai changzheng hospital during 2010.01 to 2015.12 were collected,pathological characteristics were compared between p NENs G1 ? G2?G3 grade levels.2.83 cases who have CT image datas(including other hospital CT image datas and our hospital CT image datas)were chosen from 266 cases of p NENs,the preoperative CT image features were reviewed and compared between G1 grade p NENs and G2 grade levels.56 cases who have our hospital CT image datas were screened from 83 cases.Arterial,portal,delayed CT value of the tumor and normal tissue datas were measured.Further analysis of CT image datas were carried out to compare G1 p NENs and G2 p NENs CT imaging features.ROC analysis was performed to explore the significance of relative and absolute CT value in the diagnosis of p NENs G1 and G2.Results1.In the distribution of pathological charactreistics,G2 grade pancreatic neuroendocrine neoplasm patients have a significantly larger tumor size than the G1 grade pancreatic neuroendocrine tumor patients(4.9±3.0 VS 2.9±2.3;P < 0.01).G2 gradepancreatic neuroendocrine neoplasm patients have a significantly higher infiltrating growth behavior than the G1 grade pancreatic neuroendocrine neoplasm patients(55% VS 27%;P<0.01).G2 gradepancreatic neuroendocrine neoplasm patients have a significant higher proportion of lymph node metastasis than the G1 grade pancreatic neuroendocrine neoplasm patients(18% VS 4%;P<0.01).G2 grade p NENs have a higher proportion of distant metastasis than G1 grade,although there was no statistically significant difference(6% VS 1%;P=0.09).In terms of nerve invasion,there was no statistically significant difference between p NENs G1 and G2.G3 grade pancreatic neuroendocrine neoplasm patients have a significantly larger tumor size than the G1 grade pancreatic neuroendocrine tumor patients(4.4±2.5 VS 2.9±2.3;P<0.01).G3 grade pancreatic neuroendocrine neoplasm patients have a significantly higher infiltrating growth behavior than the G1 grade pancreatic neuroendocrine neoplasm patients(83% VS 27%;P<0.01).G3 grade pancreatic neuroendocrine neoplasm patients have a significant higher proportion of lymph node metastasis than the G1 grade pancreatic neuroendocrine neoplasm patients(50% VS 4%;P<0.01).G3 grade p NENs have a higher proportion of distant metastasis than G1 grade(25% VS 1%;P<0.01).There was statistically significant difference in the distribution of TNM stage between p NENs G2 and G3.There was no statistically significant difference in tumor size between p NENs G2 and G3(4.4±2.5 VS 4.9±3.0;P=0.58).G3 grade pancreatic neuroendocrine neoplasm patients have a higher infiltrating growth behavior than G2 grade pancreatic neuroendocrine neoplasm patients,although there was no statistically significant difference(83% VS 55%;P=0.07).G3 grade pancreatic neuroendocrine neoplasm patients have a significant higher proportion of lymph node metastasis than the G2 grade pancreatic neuroendocrine neoplasm patients(50% VS 18%;P<0.01).G3 grade p NENs have a higher proportion of distant metastasis than G1 grade(25% VS 6%;P<0.01).2.G2 grade pancreatic neuroendocrine neoplasm patients have a significantly larger tumor size than G1 grade pancreatic neuroendocrine tumor patients(47.4 ± 28.9 VS 28.6 ± 17.7;P < 0.01)in the CT imaging characteristics.Both absolute and relative CT value at arterial phase,portal phase and absolute CT value at delayed phase were significantly higher in G2 p NENs than in G1(P<0.01).Moreover,ROC analysis demonstrated that absolute and relative CT value at arterial phase,portal phase and absolute CT value at delayed phase could differentiate efficiently G1 patients from G2 patients.Conclusions1.On the distribution of pathological characteristics,compared G1 p NENs,G2 pancreatic neuroendocrine neoplasm patients had a bigger tumor size,occurred more invasive growth,had more lymph node metastasis and distant metastasis.Statistical differences exist in the AJCC staging distribution;Compared G1 p NENs,G3 pancreatic neuroendocrine neoplasm patients had a bigger tumor size,occurred more invasive growth,had more lymph node metastasis and distant metastasis.Statistical differences also exist in the AJCC staging distribution.Compared G2 p NENs,G3 pancreatic neuroendocrine neoplasm patients occurred more invasive growth,had more lymph node metastasis and distant metastasis.Statistical differences also exist in the AJCC staging distribution.But there was no statistically significant difference in the size.2.CT characteristics were different between G1 and G2 p NENs.G2 p NENs had a lager size than G1 p NENs.Absolute and relative CT value at arterial phase,portal phase and absolute CT value at delayed phase could be used for preoperative assessment of G1 and G2 p NENs.