フルテキストURL J_Gastroenterol_Hepatol_62_4_925.pdf
著者 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|
抄録 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.
キーワード WHO2010 dynamic CT microvessel density pancreatic neuroendocrine neoplasm pathological grade
備考 This is an Accepted Manuscript of an article published by John Wiley & Sons
発行日 2017-04
出版物タイトル Journal of Gastroenterology and Hepatology
出版者 John Wiley & Sons
開始ページ 925
終了ページ 931
ISSN 0815-9319
NCID AA10727383
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
論文のバージョン author
PubMed ID 27637470
DOI 10.1111/jgh.13594
Web of Sience KeyUT 000398534100030
関連URL isVersionOf https://doi.org/10.1111/jgh.13594