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Digestive Diseases and Sciences

, Volume 63, Issue 11, pp 3147–3152 | Cite as

Simple Vascular Architecture Classification in Predicting Pancreatic Neuroendocrine Tumor Grade and Prognosis

  • Ke Chen
  • Wenming Zhang
  • Zhaozhen Zhang
  • Yiping He
  • Yuan Liu
  • Xiujiang Yang
Original Article
  • 55 Downloads

Abstract

Background and Aim

Vascularity is a critical feature in the evaluation of pancreatic neuroendocrine tumor (PNET). When done by EUS, contrast agents are recommended. However, vascular architecture (VA) can also be evaluated by routine Doppler flow in EUS without contrast agents. Our aim was to provide a simple VA classification in EUS for PNET grade and prognosis.

Methods

All pathologically proven PNET cases with EUS between 2012 and 2018 were retrospectively analyzed. The Doppler imaging was retrieved for VA classification. Predictive model construction was performed by machine learning algorithms.

Results

A total of 112 PNET cases were evaluated, among which 93 cases were subjected to VA classification. The VA was classified into type A (peritumoral with or without intratumoral vessels [A1 or A2]); type B (only intratumoral vessels); and type C (flow was absent). The VA classification was significantly correlated with tumor grades: 74% type A1 was G1, 73% type B was G2, and 58% type C was G3. Multivariate analysis indicated that elevated serum CA19-9 and type C classification were the independent predictors of G3 tumor. Five machine learning models were constructed, among which random forest was the best one with an AUC of 0.9972. Low-risk patients classified by this model exhibited better prognosis than high-risk patients (p = 0.0087).

Conclusions

In the novel simple VA classification, peritumoral, intratumoral, and absent vessels are prone to be G1, G2, and G3, respectively. Combined with serum CA19-9 and lesion size, the VA classification could predict tumor grade and prognosis in PNET.

Keywords

Pancreatic neuroendocrine tumor Endosonographic Staging Tumor grade Prognosis 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

10620_2018_5240_MOESM1_ESM.tif (5.5 mb)
Supplemental Fig. 1. Bar graph of the variable importance of each item for the random forest model (TIFF 5630 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ke Chen
    • 1
    • 2
  • Wenming Zhang
    • 1
    • 2
  • Zhaozhen Zhang
    • 1
    • 2
  • Yiping He
    • 1
    • 2
  • Yuan Liu
    • 1
    • 2
  • Xiujiang Yang
    • 1
    • 2
  1. 1.Department of EndoscopyFudan University Shanghai Cancer CenterShanghaiChina
  2. 2.Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina

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