Utility of contrast-enhanced harmonic endoscopic ultrasonography for predicting the prognosis of pancreatic neuroendocrine neoplasms.

contrast-enhanced harmonic endoscopic ultrasonography endoscopic ultrasonography pancreatic neuroendocrine tumor sonazoid

Journal

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 20 04 2020
accepted: 28 09 2020
pubmed: 7 10 2020
medline: 29 7 2021
entrez: 6 10 2020
Statut: ppublish

Résumé

Pancreatic neuroendocrine neoplasms (PanNENs), including Grade 1 (G1) or G2 tumors, can have a poor prognosis. This study investigated the value of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for predicting the prognosis of PanNENs. This single-center, retrospective study included 47 consecutive patients who underwent CH-EUS and were diagnosed with PanNEN by surgical resection or EUS-guided fine needle aspiration between December 2011 and February 2016. Patients were divided into aggressive and non-aggressive groups according to the degree of clinical malignancy. CH-EUS was assessed regarding its capacity for diagnosing aggressive PanNEN, the correspondence between contrast patterns and pathological features, and its ability to predict the prognosis of PanNEN. There were 19 cases of aggressive PanNEN and 28 cases of non-aggressive PanNEN. The aggressive group included three G1, four G2, three G3 tumors, three mixed neuroendocrine non-neuroendocrine neoplasms, and six neuroendocrine carcinomas. CH-EUS was superior to contrast-enhanced computed tomography for the diagnosis of aggressive PanNEN (P < 0.001): hypo-enhancement on CH-EUS was an indicator of aggressive PanNEN, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 94.7%, 100%, 100%, 96.6%, and 97.9%, respectively. Among G1/G2 PanNENs, cases with hypo-enhancement on CH-EUS had a poorer prognosis than those with hyper/iso-enhancement (P = 0.0009). Assessment of 36 resected specimens showed that hypo-enhancement on CH-EUS was associated with smaller and fewer vessels and greater degree of fibrosis. Contrast-enhanced harmonic endoscopic ultrasonography may be useful for predicting the prognosis of PanNENs.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Pancreatic neuroendocrine neoplasms (PanNENs), including Grade 1 (G1) or G2 tumors, can have a poor prognosis. This study investigated the value of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for predicting the prognosis of PanNENs.
METHODS METHODS
This single-center, retrospective study included 47 consecutive patients who underwent CH-EUS and were diagnosed with PanNEN by surgical resection or EUS-guided fine needle aspiration between December 2011 and February 2016. Patients were divided into aggressive and non-aggressive groups according to the degree of clinical malignancy. CH-EUS was assessed regarding its capacity for diagnosing aggressive PanNEN, the correspondence between contrast patterns and pathological features, and its ability to predict the prognosis of PanNEN.
RESULTS RESULTS
There were 19 cases of aggressive PanNEN and 28 cases of non-aggressive PanNEN. The aggressive group included three G1, four G2, three G3 tumors, three mixed neuroendocrine non-neuroendocrine neoplasms, and six neuroendocrine carcinomas. CH-EUS was superior to contrast-enhanced computed tomography for the diagnosis of aggressive PanNEN (P < 0.001): hypo-enhancement on CH-EUS was an indicator of aggressive PanNEN, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 94.7%, 100%, 100%, 96.6%, and 97.9%, respectively. Among G1/G2 PanNENs, cases with hypo-enhancement on CH-EUS had a poorer prognosis than those with hyper/iso-enhancement (P = 0.0009). Assessment of 36 resected specimens showed that hypo-enhancement on CH-EUS was associated with smaller and fewer vessels and greater degree of fibrosis.
CONCLUSION CONCLUSIONS
Contrast-enhanced harmonic endoscopic ultrasonography may be useful for predicting the prognosis of PanNENs.

Identifiants

pubmed: 33020955
doi: 10.1111/den.13862
doi:

Substances chimiques

Contrast Media 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

829-839

Informations de copyright

© 2020 Japan Gastroenterological Endoscopy Society.

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Auteurs

Rei Ishikawa (R)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Ken Kamata (K)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Akane Hara (A)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Hidekazu Tanaka (H)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Ayana Okamoto (A)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Tomohiro Yamazaki (T)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Atsushi Nakai (A)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Shunsuke Omoto (S)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Kosuke Minaga (K)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Kentaro Yamao (K)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Mamoru Takenaka (M)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Yasunori Minami (Y)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Tomohiro Watanabe (T)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

Yasutaka Chiba (Y)

Clinical Research Center, Faculty of Medicine, Kindai University, Osaka, Japan.

Takaaki Chikugo (T)

Department of Diagnostic Pathology, Kindai University Hospital, Osaka, Japan.

Ippei Matsumoto (I)

Departments of, Department of, Surgery, Faculty of Medicine, Kindai University, Osaka, Japan.

Yoshifumfi Takeyama (Y)

Departments of, Department of, Surgery, Faculty of Medicine, Kindai University, Osaka, Japan.

Yuko Matsukubo (Y)

Department of, Radiology, Kindai University Faculty of Medicine, Osaka, Japan.

Tomoko Hyodo (T)

Department of, Radiology, Kindai University Faculty of Medicine, Osaka, Japan.

Masatoshi Kudo (M)

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan.

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