Objective To summary the pathogenic site, clinical manifestations, endoscopic and radiographic features, pathologic characteristics, diagnosis, treatment, and prognosis of gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN). Methods Clinical data of 70 cases of GEP-NEN who were treated in Nanjing Drum Tower Hospital from Jan. 2003 to Dec. 2012 were collected and retrospectively analyzed. Results Of the 70 cases, 35 cases(50.0%) were in pancreas, 18 cases(25.7%) were in rectum, 10 cases(14.3%) were in stomach, and 7 cases(10.0%) were in appendix; 55 cases(78.6%) were nonfunctional tumors, while 15 cases(21.4%) were functional; 50 cases(71.4%) were neuroendocrine tumor, 15 cases(21.4%) were neuroendocrine carcinoma, and 5 cases(7.2%) were mixed adenoendocrine carcinoma; 43 cases(61.4%) were in grade 1, 7 cases(10.0%) were in grade 2, and 20 cases(28.6%) were in grade 3 respectively. The detection rate of endoscopy, type-B ultrasonic, CT, and MRI were 90.0%(27/30), 67.9% (19/28), 86.0%(43/50), and 70.0%(7/10) respectively. A total of 67 patients(95.7%) were underwent surgery, including endoscopic resection, and 3 cases (4.3%) didn't receive surgery. Forty cases were followed-up for 6 months to 9 years(the median survival time was 3 years), and the 1-, 3-, and 5-year survival rates were 82.5%(33/40), 47.5%(19/40), and 35.0%(14/40) respectively. Conclusion GEP-NEN occurs mainly in pancreas, and the clinical manifestations are variable. Endoscopy and radiographic examination methods play an important role in diagnosis of GEP-NEN, but final diagnosis is mainly based on pathological detection. Surgery is the main treatment method for it.
Objective To explore CT features that can be used to identify nonhypervascular pancreatic neuroendocrine neoplasm (pNEN) and pancreatic ductal adenocarcinoma (PDAC). Methods The patients with pathologically confirmed the pNEN and PDAC were retrospectively included from May 2010 to May 2017. The CT features were analyzed. The CT features were extracted by the multivariate logistic regression, and their diagnostic performances were calculated. Results Forty patients with the nonhypervascular pNEN (33 unfunctional, 7 functional) and 80 patients with the PDAC were included in this study. The features of significant differences between the nonhypervascular pNEN and the PDAC included: the location, long diameter, margin, uniform lesions, calcification, and vascular shadows of the lesion (P<0.05). The margin ［OR=14.63, 95% CI (2.82, 75.99)］, calcification ［OR=4.00, 95% CI (1.03, 15.59)］, and location ［OR=3.09, 95% CI(1.19, 7.99)］ of the lesion could independently identify the nonhypervascular pNEN. The multivariate logistic regression model of the differential diagnosis of the nonhypervascular pNEN and PDAC was obtained through the CT features of significant differences. The diagnostic sensitivity was 70.00%, 95% CI (53.5,83.4); specificity was 83.54%, 95% CI (73.5, 90.9); and area under the receiver operating curve was 0.824, 95% CI (0.743, 0.887). Conclusions Multivariate logistic regression model of CT features is helpful for differential diagnosis of nonhypervascular pNEN and PDAC. Features of margin and calcification of lesion are more valuable in differential diagnosis of nonhypervascular pNEN and PDAC.
ObjectiveTo investigate current status and hot issues of pancreatic neuroendocrine neoplasm (pNEN) imaging research.MethodsThe literatures focusing on pNEN and published from 1998 to 2018 were retrieved from the core database of Web of Science. The quantitative analysis of literatures was then conducted by using the CiteSpace software based on the bibliometrics method. The research trend was then summarized systematically and the potential research fronts and focuses were explored.ResultsA total of 190 articles in the field of pNEN imaging research were retrieved, and the top three countries in the literatures were the United States, Germany, and Italy. The clustering of co-citation of pNEN included the endoscopic ultrasound, current diagnosis, prospective evaluation, cystic pancreatic neuroendocrine tumor, hypervascular neuroendocrine tumor, nonfunctioning pancreatic neuroendocrine tumor, intravoxel incoherent motion, and metastastic lesion. The hot of keywords in the field of pNEN included the fine needle aspiration, CT, diagnosis, pancreas, cancer, neuroendocrine tumor, neoplasm, carcinoma, and management. The hot keywords clustering had the neuroendocrine tumor, pancreatic mass size, non-hyperfunctioning neuroendocrine tumor, CT appearance, metastatic lesion, ancillary studies, somatostatin analogues, somatostatinoma, intraoperative ultrasound, and multiple endcorine neoplasia 1.ConclusionAccurate imaging diagnosis of pNEN is still a hot issue in this field.