Related Studies of Imaging Features and Prognosis Between Pancreatic Neuroendocrine Tumors and Pancreatic Cancer

Grade 3 Pancreatic Neuroendocrine Tumors on MDCT: Establishing a Diagnostic Model and Comparing Survival Against Pancreatic Ductal Adenocarcinoma

1. Imaging findings (including CT and MRI images) of both well-differentiated G3 PNET and poorly differentiated PNET were studied;
2. The CT imaging findings of G3 stage PNET and pancreatic cancer were compared to establish a Logistic regression diagnostic model, and the survival analysis of the two was compared.
3. Cox regression was used to study the risk factors for survival prognosis of well-differentiated and poorly differentiated PNET based on CT image features

Study Overview

• Status: Completed
• Conditions: Carcinoma, Pancreatic; CT; Neuroendocrine Tumor of Pancreas
• Intervention / Treatment: Other: No intervention

Detailed Description

According to the latest WHO Classification of Neuroendocrine Neoplasms (NET) in 2019, pancreatic neuroendocrine neoplasms (PNET) are divided into well-differentiated and poorly differentiated PNETs.The former is divided into G1, G2, and well differentiated G3.There are few studies on the survival outcomes of these two differentiated PNET types.The G3 imaging manifestations of the two types of differentiation have not been studied yet, and G3 PNET is often clinically misdiagnosed as pancreatic cancer, so it is necessary to differentiate the imaging manifestations and survival time of the two types.

A total of 71 patients with PNET in our hospital from January 2012 to January 2019 and 58 patients with pancreatic cancer from February 2014 to August 2015 were retrospectively collected. Complete survival time data of all patients after telephone follow-up were obtained.Since G3 PNET is very rare, the investigators enrolled 9 patients with G3 PNET in the First Affiliated Hospital of Zhejiang University School of Medicine and 7 patients with G3 PNET in the Affiliated Hospital of Air Force Military Medical University from January 2013 to October 2018.

CT images of PNET and pancreatic cancer were analyzed independently by two radiologists specializing in abdominal diagnosis, in which G3 lesions were evaluated simultaneously on MRI images and the others were evaluated only on CT images.Records clinical data and imaging characteristics: gender, age, tumor markers, tumor shape, size, tumor characteristics, edge, the expansion of the shrinking, pancreas, pancreatic pancreatitis, enhancement scan, arterial phase and portal phase lesions and the ratio of pancreatic parenchyma around, liver metastasis, peripheral vascular invasion, lymph node metastasis.

• Study Type: Observational
• Enrollment (Actual): 78

Contacts and Locations

Study Locations

• China
  • Zhejiang
    • Hangzhou, Zhejiang, China, 310009
      • Second Affiliated Hospital of Zhejiang University School of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: ADULT; OLDER_ADULT; CHILD
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

The investigators retrospectively analyzed data for patients who underwent contrast-enhanced MDCT for the evaluation of G3 PNETs at the Second Affiliated Hospital of Zhejiang University School of Medicine (n = 12) between January 2011 and May 2019, patients with G3 PNET who underwent MDCT at the First Affiliated Hospital of Zhejiang University School of Medicine (n = 4) and the Military Medical University of Air Force (The Fourth Military Medical University) (n = 4) between January 2013 and October 2018, and consecutive patients with PDAC who underwent MDCT at the Second Affiliated Hospital of Zhejiang University School of Medicine (n = 58) from February 2014 to August 2015.

Description

Inclusion Criteria:

1. Diagnosis by pathology and detailed pathological information
2. Enhanced CT examination or biopsy were performed within 2 months before surgery
3. There was no preoperative radiotherapy or chemotherapy

Exclusion Criteria:

1. No Ki-67 index
2. CT value cannot be measured by ROI because of pancreatic atrophy and other reasons
3. No enhanced images or missing images

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Group PNETs; The investigators retrospectively analyzed data for patients who underwent contrast-enhanced MDCT for the evaluation of G3 PNETs at the Second Affiliated Hospital of Zhejiang University School of Medicine (n = 12) between January 2011 and May 2019, patients with G3 PNET who underwent MDCT at the First Affiliated Hospital of Zhejiang University School of Medicine (n = 4) and the Military Medical University of Air Force (The Fourth Military Medical University) (n = 4) between January 2013 and October 2018	Other: No intervention; Retrospective study without intervention
Group PDAC; Patients with PDAC who underwent MDCT at the Second Affiliated Hospital of Zhejiang University School of Medicine (n = 58) from February 2014 to August 2015.	Other: No intervention; Retrospective study without intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Tumor size	Maximum surface size of the lesion (cm)	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Tumor location	Locations of the pancreas: head, neck, body and tail	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Number of lesions	Number of lesions	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Margin	well-defined or ill-defined	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
tumor texture	solid；solid and cystic；complex cystic	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Pancreatic tail contraction	yes or no	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Complicated pancreatitis	yes or no	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Pancreatic duct/bile duct dilatation	yes or no	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Extrapancreatic tissue invasion	yes or no	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Hepatic metastasis	yes or no	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
Lymphatic metastasis	yes or no	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
CT value of pancreas plain scan	CT value of pancreas plain scan	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
CT value of lesion plain scan	CT value of lesion plain scan	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
CT value of pancreas artery phase	CT value of pancreas artery phase	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
CT value of lesion artery phase	CT value of lesion artery phase	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
CT value of pancreas portal phase	CT value of pancreas portal phase	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy
CT value of lesion portal phase	CT value of lesion portal phase	preoperative contrast-enhanced CT performed within 2 months before surgery or biopsy

Collaborators and Investigators

• Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University
• Collaborators: Zhejiang University; The First Affiliated Hospital of the Fourth Military Medical University
• Investigators: Principal Investigator: Risheng Yu, Second Affiliated Hospital of Zhejiang University School of Medicine

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2012
• Primary Completion (ACTUAL): January 1, 2019
• Study Completion (ACTUAL): June 25, 2019

Study Registration Dates

• First Submitted: July 12, 2021
• First Submitted That Met QC Criteria: July 25, 2021
• First Posted (ACTUAL): July 27, 2021

Study Record Updates

• Last Update Posted (ACTUAL): July 27, 2021
• Last Update Submitted That Met QC Criteria: July 25, 2021
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms by Histologic Type; Neoplasms; Neoplasms by Site; Endocrine System Diseases; Digestive System Neoplasms; Endocrine Gland Neoplasms; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms, Nerve Tissue; Pancreatic Diseases; Pancreatic Neoplasms; Neuroendocrine Tumors
• Other Study ID Numbers: yurisheng

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No