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Research Hotspots Analysis on Imaging of Pancreatic Neuroendocrine Tumor on Bibliometrics

ObjectiveTo investigate the hotspots from researches on imaging of pancreatic neuroendocrine tumor in recent five years. MethodsThe bibliographies from research literatures on imaging of pancreatic neuroendocrine tumor from 2010 to 2015 in PubMed database were downloaded. The Bicomb 2.0 bibliographies analysis software was used to count high-frequency of Mesh major topics (MJMEs). SPSS 22.0 statistical software was applied for clustering analysis with MJMEs, then to get the topic hotspots. ResultsA total of 357 literatures were screened out during the years of 2010-2015. The MJMEs which frequency > 13 were 28. Taken the 28 MJMEs into clustering analysis, then three research hotspots were clustered. ConclusionResearches on imaging of the pancreatic neuroendocrine tumor in recent five years are mainly in terms of imaging techniques, a comparative study of pathology and endoscopic ultrasonography-fine needle aspiration, imaging and disease treatment.

The Advance in Diagnosis and Treatment on Large Cell Neuroendocrine Lung Cancer

Large cell neuroendocrine lung cancer（LCNEC） is the rare subtype of nonsmall cell lung cancer. Because of its low incidence rate and the special biological behaviour, it is hard to define in pathology. And we also know little about its epidemiological feature and the purposeful therapy view of LCNEC, and the therapeutic effect is unsatisfactory. This article will review and introduce the advance of research, clinical diagnosis and therapeutic of the LCNEC.

Clinical Analysis of 16 Patients with Rectal Neuroendocrine Neoplasm

目的总结直肠神经内分泌肿瘤（RNEN）的临床诊断和治疗方法。 方法回顾性分析2009年1月至2013年12月期间南京中医药大学附属医院（江苏省中医院）收治的16例RNEN患者的临床资料。 结果16例患者均顺利完成手术，手术时间30～120 min，平均50 min；术中出血量10～80 mL，平均55 mL；均无手术死亡，术中均未见严重并发症发生。术后住院时间10～35 d，平均17 d。手术创面均一期愈合，均顺利出院。术后所有患者均获访，随访时间为2个月～5年，中位随访时间为20个月。随访期间所有患者均未见复发或转移，无死亡病例。 结论RNEN发病隐匿，具有恶性潜能，且常无特异性临床表现，故应加深对该病的认识，及时对就诊患者进行全面检查，做到早发现、早诊断及早治疗，且治疗后应对患者进行严密随访。

Treatment of Primary Hyperparathyroidism

Present and Advance in Surgical Diagnosis and Treatment of Pancreatic Endocrine Tumors

Objective　To approach the recent advances in diagnosis and surgical treatment of pancreatic endocrine tumors （PETs）. Methods　Articles relevant to diagnosis and treatment of PETs were collected and reviewed. Results　PETs are characterized by their ability to over-produce peptides and hormones， which cause specific clinical syndromes. Because of rare incidence and complex clinical syndromes， there are still impediments to early diagnosis of these tumors. Monitoring of serum hormones and imaging method allow early tumor detection. PETs have been investigated for the past several decades. With the great knowledge of these tumors in molecular genetic level， clinical managements have been greatly changed. Conclusions　Avoiding misdiagnosis is important for treatment of PETs. Surgical approach is still considered as the preferred option for curtailing the malignant progression of PETs and controlling the associated biochemical syndromes.

胰腺神经内分泌肿瘤的治疗进展

胰腺神经内分泌肿瘤（PNET）是来源自胰腺多能神经内分泌干细胞的一种罕见的胰腺肿瘤，临床表现复杂多样，病程缓慢, 最终发生转移致死。PNET分为功能性和非功能性，目前治疗有手术、化学疗法、放射治疗、介入、生物治疗以及分子靶向药物治疗，近年生物治疗及分子靶向药物治疗在研究中显示出了良好疗效。根据国内外文献及最新临床试验研究进展，现就PNET治疗进展进行综述。

The Clinical Analysis of 74 Cases with Gastrointestinal Neuroendocrine Neoplasm

ObjectiveTo investigate the clinical characteristic and treatment of gastrointestinal neuroendocrine neoplasm. MethodsFrom January 2011 to July 2015, the clinical characteristic and treatment of 74 patients with gastrointestinal neuroendocrine neoplasm in The Affiliated Hospital of Xuzhou Medical College were retrospectively analyzed. ResultsCases of gastrointestinal neuroendocrine neoplasm were increasing year by year. This study includes statistics of 74 patients. The number of male and female were 47 and 27, the rate was 1.74:1, the median age was 57.5 years old ranging from 24 up to 82 years. Of all the 74 cases, there were 38 cases (51.4%) in the stomach, 23 cases (31.1%) in rectum, 12 cases (16.2%) in colon, 1 case in duodenum. Of all the 74 cases with clinical symptom information, non-functional symptom accounts for 95.9% (71/74), while functional symptom accounts only for 4.1% (3/74). There were treatment data of 74 cases, including 34 cases in radical surgery, 23 cases in endoscopic excision, 8 cases in local resection, 4 cases in palliative resection, and 5cases in conservative treatment. The lymphatic metastasis was associated with gender, tumor size, tumor depth of invasion and tumor differentiation (P < 0.05). There was no statistically significant between the lymphatic metastasis and tumor location (P > 0.05). Preoperative distant metastasis was associated with tumor size and tumor depth of invasion (P < 0.05). Syn had a higher positive rate than CgA (P < 0.01). The positive rate of Syn and CgA was respectively 96.1% (49/51) and 72.9% (35/48). Conciusions Cases of gastrointestinal neuroendocrine neoplasm are increasing year by year, of which men has a higher morbidity than women. Radical surgery and endoscopic resection are the main treatment methods. The Syn and CgA test are helpful to the diagnosis of gastrointestinal neuroendocrine neoplasm.

CT features differentiate nonhypervascular pancreatic neuroendocrine neoplasm and pancreatic ductal adenocarcinoma: preliminary study

Objective To explore CT features that can be used to identify nonhypervascular pancreatic neuroendocrine neoplasm (pNEN) and pancreatic ductal adenocarcinoma (PDAC). Methods The patients with pathologically confirmed the pNEN and PDAC were retrospectively included from May 2010 to May 2017. The CT features were analyzed. The CT features were extracted by the multivariate logistic regression, and their diagnostic performances were calculated. Results Forty patients with the nonhypervascular pNEN (33 unfunctional, 7 functional) and 80 patients with the PDAC were included in this study. The features of significant differences between the nonhypervascular pNEN and the PDAC included: the location, long diameter, margin, uniform lesions, calcification, and vascular shadows of the lesion (P<0.05). The margin ［OR=14.63, 95% CI (2.82, 75.99)］, calcification ［OR=4.00, 95% CI (1.03, 15.59)］, and location ［OR=3.09, 95% CI(1.19, 7.99)］ of the lesion could independently identify the nonhypervascular pNEN. The multivariate logistic regression model of the differential diagnosis of the nonhypervascular pNEN and PDAC was obtained through the CT features of significant differences. The diagnostic sensitivity was 70.00%, 95% CI (53.5,83.4); specificity was 83.54%, 95% CI (73.5, 90.9); and area under the receiver operating curve was 0.824, 95% CI (0.743, 0.887). Conclusions Multivariate logistic regression model of CT features is helpful for differential diagnosis of nonhypervascular pNEN and PDAC. Features of margin and calcification of lesion are more valuable in differential diagnosis of nonhypervascular pNEN and PDAC.

Comprehensive Treatment of Pancreatic Neuroendocrine Neoplasms

ObjectiveTo summary the treatment of pancreatic neuroendocrine neoplasms (pNENs). MethodsArticles relevant to pNENs at home and abroad were collected and reviewed. ResultsBecause of rare incidence and non-specific clinical syndromes of pNENs, clinician had no enough cognition about it. For pNENs, surgery was still the preferred option, combining other treatments included chemotherapy, somatostatin analogue, α-interferon, molecular targeted therapy, and peptide receptor radionuclide therapy (PRRT). ConclusionSurgery is still considered as the preferred option for controlling the associated biochemical syndromes and curtailing the malignant progression of pNENs.

不同病理分级胰腺神经内分泌肿瘤的影像特征分析

目的初步探讨不同病理分级的胰腺神经内分泌肿瘤的CT和MRI表现特点。 方法回顾性分析2013年1月至2015年12月期间于笔者所在医院经穿刺及手术病理学检查证实的15例胰腺神经内分泌肿瘤患者的临床及影像资料，根据2010年WHO第4版“神经内分泌肿瘤病理分类标准”分为G1、G2及G3级后进行分析。 结果15例患者中，8例有神经内分泌症状，5例主要症状为腹痛，2例无任何症状；G1、G2及G3级各5例。15例患者共检出17个病灶（G1级5个，G2级5个，G3级7个），肿瘤主要位于胰体尾部（9个，其中G1级1个，G2级和G3级均为4个），其次为胰头（7个，其中G1级3个，G2级1个，G3级3个）；1个病灶内有钙化点（G2级），9个病灶内可见坏死（G1级2个，G2级4个，G3级3个）；10个病灶形态为类圆形（G1级3个，G2级3个，G3级4个），7个为不规则形（G1级2个，G2级2个，G3级3个）；10个病灶位于胰腺轮廓内（G1级4个，G2级3个，G3级3个），7个位于胰腺轮廓外（G1级1个，G2级2个，G3级4个）。CT平扫示17个病灶均为等或低密度，有坏死者密度不均。MRI检查示：5个病灶T1WI为低信号，T2WI为高信号（G1级1个，G2级1个，G3级3个）；2个病灶T1WI为低信号，T2WI为等信号（G1级1个，G2级1个）；1个病灶T1WI及T2WI均为等信号（G1级）。病灶强化方式：1个病灶表现为动脉期明显强化，门静脉期强化密度降低（G1级）；8个病灶表现为动脉期和门静脉期均明显强化（G1级3个，G2级4个，G3级1个），8个病灶表现为动脉期轻度-较明显强化，门静脉期进一步明显强化（G1级1个，G2级1个，G3级6个）。1例G1级及1例G2级病例发生肝脏转移，1例G3级病例发生肝脏多发转移及L2椎体骨转移，另1例G3级病例有门腔间隙淋巴结肿大。 结论各级别胰腺神经内分泌肿瘤的影像表现不具有特异性，尚需进一步大样本研究。