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目的根据所发现转移瘤的位置,预测胃肠道原发内分泌肿瘤的部位。材料与方法研究来自一个或多个癌症研究中心的250例在病理上确诊为神经内分泌肿瘤病人的影像学数据。在可成像的模式(如CT、PET/CT、MRI、奥曲肽扫描)的病理或影像学报告中收集原发肿瘤与转移瘤部位的数据。使用标准的回归模型,根据转移瘤的位置来预测原发肿瘤的位置。在逐步研究的过程中,如果回归系数的统计学结果显示P>0.05则被剔除。结果肺与肝的转移瘤在预测原发肿瘤位置方面差异无统计学意义(分别为P=0.86和0.074),然而,淋巴结、骨、腹膜转移预测原发肿瘤位置差异有统计学意义(分别为P<0.0001、0.0004和0.014)。结论神经内分泌肿瘤转移到淋巴结、骨、腹膜可以预测原发神经内分泌肿瘤的位置;然而,仅发生于肺与肝的转移瘤不能预测原发肿瘤的位置。要点①医学影像可有助于诊断原发神经内分泌肿瘤的位置及其与转移瘤的关系。②弥漫的转移性疾病使诊断原发病变困难。③预测模型的开发可以帮助确定原发肿瘤的位置。④这种方法可以确定隐藏的转移瘤,从而有助于对其处理。
Objective To predict the location of the primary gastrointestinal endocrine tumor based on the location of metastases found. Materials and Methods Imaging data from 250 patients with pathologically diagnosed neuroendocrine tumors were studied from one or more cancer research centers. Data on primary tumor and metastases sites were collected in pathological or imaging reports of imageable modalities (eg, CT, PET / CT, MRI, octreotide scan). Using a standard regression model, the location of the primary tumor is predicted based on the location of the metastases. In a step-by-step study, if the regression coefficient of the statistical results showed that P> 0.05 was removed. Results There was no significant difference in the prediction of primary tumor location between lung and liver metastases (P = 0.86 and 0.074, respectively). However, there was significant difference in the location of primary tumor between lymph node, bone and peritoneal metastasis P <0.0001, 0.0004 and 0.014). Conclusion The metastasis of neuroendocrine tumors to the lymph nodes, bone and peritoneum can predict the location of primary neuroendocrine tumors; however, metastases that occur only in lung and liver can not predict the location of the primary tumor. Points ① Medical imaging can help diagnose the location of primary neuroendocrine tumors and their relationship to metastases. ② diffuse metastatic disease diagnosis of primary lesions difficult. The development of predictive models can help determine the location of the primary tumor. ④ This method can determine the hidden metastases, which helps to deal with it.