超声内镜联合Photoshop软件在不同级别直肠神经内分泌肿瘤中的鉴别应用

Differential diagnosis of Photoshop combined with endoscopic ultrasonography in differential levels of rectal neuroendocrine neoplasm

摘要:

目的 探讨Photoshop（PS）软件联合超声内镜（EUS）在不同级别直肠神经内分泌肿瘤（NENs）中的应用价值。方法 选择温州市三大医院140例经病理及免疫组化确诊且均行EUS的NENs患者，收集相关临床资料和EUS图片，根据肿瘤的病理核分裂象及免疫组化Ki-67指数，将直肠NENs分为低级别组（G1组）和中级别组（G2组）。利用PS软件测定各组病灶EUS图像的灰度平均值和灰度值标准偏差，并统计分析各组的差异。结果 G1组有126例直肠NENs，G2组14例，两组在年龄、性别和病理浸润层次方面比较，差异均无统计学意义（P > 0.05）。两组在色泽、黏膜是否光滑、形状和回声异质性方面比较，差异均无统计学意义（P > 0.05）。G1组平均直径为（0.59±0.23）cm，G2组为（0.96±0.39）cm，两组比较，差异有统计学意义（P < 0.05）；G1组EUS下表现为低回声102例，中回声24例，G2组表现为低回声8例，中回声6例，两组比较，差异有统计学意义（P < 0.05）；PS软件分析发现，G1组EUS图像的灰度平均值为（33.76±7.21），G2组为（48.19±10.34），两组比较，差异有统计学意义（P < 0.05）；G1组EUS图像的灰度值标准偏差为（11.33±2.69），而G2组为（12.82±2.98），两组比较，差异无统计学意义（P > 0.05）。结论 直肠NENs G2级平均直径大于G1级，EUS下G2级回声强度高于G1级，EUS联合PS软件对直肠NENs分级有一定的帮助。

Abstract:

Objective To investigate the application value of Photoshop combined with ultrasonography in different level of rectal neuroendocrine neoplasms (NENs).Methods Clinical characteristics and EUS image of 140 cases of rectal NENs diagnosed by pathology and immunohistochemistry examination were collected. According to pathological mitotic figure and Ki-67 index, NENs were divided into two groups, low grade group (G1) and middle grade group (G2). Mean gray value (represent intensity of echo) and gray value standard deviation (represent uniformity of echo) of EUS images of the lesions were determined by Photoshop and statistical analysis was done to find the differences of each group.Results 126 G1 grade and 14 G2 grade of rectal NENs were included in this study. There was no significant difference in age, gender, and pathological infiltration level between G1 and G2 grade group (P > 0.05). There was no significant difference in color, whether the mucosa was smooth, shape, and echo heterogeneity between G1 and G2 grade group (P > 0.05). The average size of G1 grade group and G2 grade group was (0.59 ± 0.23) cm, (0.96 ± 0.39) cm respectively (P < 0.05); There were 102 cases of low echo and 24 cases of medium echo in G1 grade under EUS, and in G2 grade, there were 8 cases of low echo and 6 cases of medium echo, the difference of echo intensity between the two groups was of statistical significance (P < 0.05). There was statistically difference of the mean gray value of EUS images in G1 group and G2 group [(33.76 ± 7.21) and (48.19 ± 10.34) respectively]. However, there was no significant difference of the mean gray value standard deviation of EUS image between the two groups [(11.33 ± 2.69) and (12.82 ± 2.98) respectively].Conclusion G2 grade rectal NENs have larger size and higher echo intensity under EUS than G1 grade NENs. EUS combined with PS software has a certain help for rectal NENs classification.