Diagnostic value and influencing factors of endoscopic ultrasonography for rectal neuroendocrine neoplasms
10.3760/cma.j.cn321463-20240826-00195
- VernacularTitle:超声内镜对直肠神经内分泌肿瘤的诊断价值及影响因素研究
- Author:
Xiaotong WANG
1
;
Xiaowei WANG
1
;
Wenjun ZHAO
1
;
Zeyuan DIAO
1
;
Wen SONG
1
;
Yao LIU
1
;
Zhenzhen SUI
1
;
Ya LIU
1
;
Hua LIU
1
Author Information
1. 青岛大学附属医院消化内科，青岛 266000
- Publication Type:Journal Article
- Keywords:
Neuroendocrine tumors;
Rectum;
Endoscopic ultrasonography;
Diagnosis
- From:
Chinese Journal of Digestive Endoscopy
2025;42(6):474-479
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic value and influencing factors of endoscopic ultrasonography (EUS) for detecting rectal neuroendocrine neoplasms (R-NENs).Methods:A retrospective case-control study was performed on data of patients with suspected R-NENs by white light endoscopy who underwent endoscopic diagnosis and treatment or surgical operation and obtained pathological diagnosis at the Affiliated Hospital of Qingdao University from March 2016 to June 2023. Clinical data, EUS characteristics and pathological results were statistically analyzed, and the diagnostic accuracy of EUS for R-NENs were obtained by comparing the EUS results with the pathological results. Influencing factors affecting accuracy were analyzed by using the binary logistic regression model.Results:A total of 317 patients were included. The sensitivity, the specificity, the positive predictive value and the negative predictive value of EUS in diagnosing R-NENs were 98.03% (249/254), 34.92% (22/63), 85.86% (249/290) and 81.48% (22/27) respectively. The accuracy was 85.49% (271/317) and the Jorden index was 0.33. Tumor size ≤5 mm ( P=0.002, OR=2.892, 95% CI: 1.464-5.713), absence of surface vascular dilation ( P=0.019, OR=2.613, 95% CI: 1.170-5.837), normal tumor coloration ( P=0.001, OR=3.460, 95% CI: 1.645-7.279) and erythematous surface appearance ( P=0.048, OR=7.242, 95% CI: 1.015-51.680) were independent risk factors affecting the accuracy of R-NENs diagnosis by EUS. Depth assessment accuracy of EUS was 76.77% (195/254), with echo heterogeneity ( P<0.001, OR=4.008, 95% CI: 1.980-8.113) and surface depression ( P=0.035, OR=2.664, 95% CI: 1.073-6.615) emerging as significant factors affecting invasion depth evaluation. Conclusion:EUS demonstrates substantial clinical utility for R-NENs assessment, with diagnostic performance being significantly associated with tumor morphology and sonographic features. Macroscopic characteristics including tumor size, vascular patterns, and chromatic features influence diagnostic accuracy, while echo-textural heterogeneity and surface depression affect invasion depth precision. These findings underscore the clinical relevance of comprehensive EUS evaluation in R-NENs management.
