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FullText URL J_Gastroenterol_Hepatol_62_4_925.pdf
Author Horiguchi, higeru| Kato, Hironari| Shiraha, Hidenori| Tsutsumi, Koichiro| Yamamoto, Naoki| Matsumoto, Kazuyuki| Tomoda, Takeshi| Uchida, Daisuke| Akimoto, Yutaka| Mizukawa, Syou| Tanaka, Takehiro| Ichimura, Koichi| Takaki, Akinobu| Yagi, Takahito| Okada, Hiroyuki|
Abstract BACKGROUND AND AIM: Pathological grading is important in defining the therapeutic strategy in pancreatic neuroendocrine neoplasm (PNEN) but is difficult for unresectable cases. Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is useful in the diagnosis of PNEN, but its usefulness for pathological grading is not well established. No studies have examined the diagnostic ability of dynamic computed tomography (CT) for pathological grading of PNEN. We investigated the usefulness of EUS-FNA and dynamic CT in the diagnosis and pathological grading of PNEN. METHODS: In this retrospective study, 39 PNEN patients finally diagnosed via EUS-FNA and/or surgical resection underwent dynamic CT. Pathological samples were diagnosed based on WHO2010; staging was based on the European Neuroendocrine Tumor Society classification. The proportion of the quantification value in the tumor to the pancreatic parenchyma in arterial phase was defined as the CT ratio. Immunohistochemical staining with CD31 was performed to evaluate microvessel density (MVD). We evaluated the relationship between pathological grade, CT ratio, and MVD. RESULTS: By using EUS-FNA, 35 of 39 (90%) cases were diagnosed as PNEN. As for pathological grade, 15 of 35 (43%) cases could be identified correctly. CT ratio could predict pathological Grade 3 disease. The sensitivity, specificity, and diagnostic accuracy were 100%, 94%, and 95%. MVD was significantly correlated with CT ratio (r = 0.83, P < 0.0001) and pathological grade (P = 0.0074). CONCLUSIONS: Computed tomography ratio has a relationship with pathological grade in PNEN, which would help decide therapeutic strategy in unresectable cases and cases in which pathological grading is difficult.
Keywords WHO2010 dynamic CT microvessel density pancreatic neuroendocrine neoplasm pathological grade
Note This is an Accepted Manuscript of an article published by John Wiley & Sons
Published Date 2017-04
Publication Title Journal of Gastroenterology and Hepatology
Volume volume32
Issue issue4
Publisher John Wiley & Sons
Start Page 925
End Page 931
ISSN 0815-9319
NCID AA10727383
Content Type Journal Article
language 英語
OAI-PMH Set 岡山大学
Copyright Holders https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
File Version author
PubMed ID 27637470
DOI 10.1111/jgh.13594
Web of Sience KeyUT 000398534100030
Related Url isVersionOf https://doi.org/10.1111/jgh.13594