CT放射学特征在评估神经内分泌肿瘤肝转移病理学级别上的价值初探

解添淞; 刘伟; 孙静; 陈雷; 周正荣

doi:10.19732/j.cnki.2096-6210.2026.02.011

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CT放射学特征在评估神经内分泌肿瘤肝转移病理学级别上的价值初探

论著 | 更新时间：2026-05-07

- CT放射学特征在评估神经内分泌肿瘤肝转移病理学级别上的价值初探
- Preliminary study about the value of CT radiological features in predicting the pathological grade of neuroendocrine neoplasm liver metastases
- 肿瘤影像学 2026年35卷第2期页码：309-318
- 作者机构：
  
  1.复旦大学附属肿瘤医院放射诊断科，复旦大学上海医学院肿瘤学系，上海 200032
  2.福建省肿瘤医院放射诊断科，福建医科大学肿瘤临床医学院，福建福州 350014
  3.复旦大学附属肿瘤医院闵行院区影像科，上海 200240
- 作者简介：
  
  ZHOU Zhengrong　E-mail: zhouzr-16@163.com
- 基金信息：
  
  国家自然科学基金面上项目(NSFC82471981);上海市抗癌协会雏鹰计划(SACA-CY23B05);上海市抗癌协会翱翔计划(SACA-AX202309);徐汇区院地合作项目(23XHYD-13)
- DOI：10.19732/j.cnki.2096-6210.2026.02.011
  中图分类号： R735.7;R445.3
- 收稿：2025-11-14，
  
  修回：2026-01-09，
  
  纸质出版：2026-04-28
- 稿件说明：
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解添淞, 刘　伟, 孙　静, 等. CT放射学特征在评估神经内分泌肿瘤肝转移病理学级别上的价值初探［J］. 肿瘤影像学, 2026, 35(2): 309-318.

XIE T S, LIU W, SUN J, et alCitation:. Preliminary study about the value of CT radiological features in predicting the pathological grade of neuroendocrine neoplasm liver metastases［J］. Oncoradiology, 2026, 35(2): 309-318.
解添淞, 刘　伟, 孙　静, 等. CT放射学特征在评估神经内分泌肿瘤肝转移病理学级别上的价值初探［J］. 肿瘤影像学, 2026, 35(2): 309-318. DOI： 10.19732/j.cnki.2096-6210.2026.02.011.

XIE T S, LIU W, SUN J, et alCitation:. Preliminary study about the value of CT radiological features in predicting the pathological grade of neuroendocrine neoplasm liver metastases［J］. Oncoradiology, 2026, 35(2): 309-318. DOI： 10.19732/j.cnki.2096-6210.2026.02.011.

摘要

目的

探究计算机体层成像（computed tomography，CT）放射学特征在鉴别不同病理学级别的神经内分泌肿瘤（neuroendocrine neoplasm，NEN）肝转移灶上的可行性与价值。

方法

回顾并分析2021年7月—2025年4月复旦大学附属肿瘤医院的NEN肝转移患者的肝转移灶，其中G1/2级病变均由术后病理学检查证实，G3级病变由穿刺活检或术后病理学检查证实。评估肿瘤在增强CT上的定量和定性特征，分析G1/2级与G3级病变的CT放射学特征差异性，使用多因素分析筛选出对肿瘤病理学级别具有预测价值的CT特征。

结果

本研究共纳入67例NEN肝转移患者共计118枚肝转移灶，其中G1/2级72枚（61.0%），G3级46枚（39.0%）。G1/2级肝转移瘤在动脉早期、动脉晚期及静脉期的CT值均显著高于G3级肝转移瘤（均

0.001），肿瘤在动脉早期、动脉晚期及静脉期的CT值鉴别病理学级别的曲线下面积（are under curve，AUC）分别为0.713、0.714、0.681。在定性特征中，肿瘤的动脉血供、动态增强模式、囊泡征、肿瘤边缘在G1/2与G3级间差异均有统计学意义（

0.05）。多因素logistic分析表明，肿瘤血供、动态增强模式、肿瘤边缘和瘤内坏死是鉴别G1/2级和G3级NEN肝转移灶的独立预测因子，乏血供、缓慢上升型强化、肿瘤边缘模糊、瘤内广泛坏死提示G3级肝转移。

结论

CT放射学特征在无创鉴别G1/2级与G3级NEN肝转移中具有价值，有望为NEN肝转移的精准治疗提供帮助。

Abstract

Objective

To explore the feasibility and value of computed tomography (CT) radiological features in differentiating liver metastases of neuroendocrine neoplasms (NEN) with different pathological grades.

Methods

NEN patients with hepatic metastases treated at Fudan University Shanghai Cancer Center between July 2021 and April 2025 were retrospectively enrolled and analyzed. Among these cases

G1/G2 lesions were confirmed by surgical pathology

while G3 lesions were confirmed by either biopsy or surgical pathology. The quantitative and qualitative features of the tumors on enhanced CT were evaluated

the differences in CT radiological features between G1/2 and G3 lesions were analyzed

and multivariate analysis was used to identity CT features with predictive value for pathological grades.

Results

A total of 67 NEN patients with hepatic metastases (encompassing 118 hepatic metastatic lesions) were enrolled in this study. Among these lesions

(61.0%) were G1/G2

and 46 (39.0%) were G3. The CT values of G1/2 liver metastases in the early arterial phase

late arterial phase

and venous phase were significantly higher than those of G3 liver metastases (all

0.001). The areas under the curve (AUC) of CT values in the early arterial phase

late arterial phase

and venous phase for differentiating pathological grades were 0.713

0.714

and 0.681

respectively. Among qualitative features

there were significant differences in arterial blood supply

dynamic enhancement pattern

vesicle sign

and tumor margin between G1/2 and G3 grades (all

0.05). Multivariate logistic analysis showed that tumor blood supply

dynamic enhancement pattern

tumor margin

intra-tumoral necrosis were independent predictors for differentiating liver metastases of G1/2 and G3 NEN. Poor blood supply

slow-rising enhancement pattern

blurred tumor margin

and extensive intra-tumoral necrosis suggested G3 liver metastasis.

Conclusion

CT radiological features are valuable in non-invasive differentiation of G1/2 and G3 NEN liver metastases

and are expected to provide assistance for precise treatment of NEN liver metastases.

关键词

Keywords

references

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