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Ma J, Wang X, Tang M, Zhang C. Preoperative prediction of pancreatic neuroendocrine tumor grade based on 68Ga-DOTATATE PET/CT. Endocrine 2024; 83:502-510. [PMID: 37715934 PMCID: PMC10850018 DOI: 10.1007/s12020-023-03515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 08/29/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE To establish a prediction model for preoperatively predicting grade 1 and grade 2/3 tumors in patients with pancreatic neuroendocrine tumors (PNETs) based on 68Ga-DOTATATE PET/CT. METHODS Clinical data of 41 patients with PNETs were included in this study. According to the pathological results, they were divided into grade 1 and grade 2/3. 68Ga-DOTATATE PET/CT images were collected within one month before surgery. The clinical risk factors and significant radiological features were filtered, and a clinical predictive model based on these clinical and radiological features was established. 3D slicer was used to extracted 107 radiomic features from the region of interest (ROI) of 68Ga-dotata PET/CT images. The Pearson correlation coefficient (PCC), recursive feature elimination (REF) based five-fold cross validation were adopted for the radiomic feature selection, and a radiomic score was computed subsequently. The comprehensive model combining the clinical risk factors and the rad-score was established as well as the nomogram. The performance of above clinical model and comprehensive model were evaluated and compared. RESULTS Adjacent organ invasion, N staging, and M staging were the risk factors for PNET grading (p < 0.05). 12 optimal radiomic features (3 PET radiomic features, 9 CT radiomic features) were screen out. The clinical predictive model achieved an area under the curve (AUC) of 0.785. The comprehensive model has better predictive performance (AUC = 0.953). CONCLUSION We proposed a comprehensive nomogram model based on 68Ga-DOTATATE PET/CT to predict grade 1 and grade 2/3 of PNETs and assist personalized clinical diagnosis and treatment plans for patients with PNETs.
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Affiliation(s)
- Jiao Ma
- Department of Nuclear Medicine, The Affilliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, PR China
| | - Xiaoyong Wang
- Department of Radiology, The Affilliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, PR China
| | - Mingsong Tang
- Department of Radiology, The Affilliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, PR China
| | - Chunyin Zhang
- Department of Nuclear Medicine, The Affilliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, PR China.
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, PR China.
- Academician (expert) Workstation of Sichuan Province, Luzhou, 646000, Sichuan, PR China.
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A Lymph Node Ratio Model for Prognosis of Patients with Pancreatic Neuroendocrine Tumors. Biomedicines 2023; 11:biomedicines11020407. [PMID: 36830943 PMCID: PMC9953747 DOI: 10.3390/biomedicines11020407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
Abstract
The objective of this study was to determine the prognostic value of lymph node (LN) involvement and the LN ratio (LNR) and their effect on recurrence rates and survival in patients with pancreatic neuroendocrine tumors (PNETs) undergoing surgery. This single-center retrospective study reviewed the medical records of 95 consecutive patients diagnosed with PNETs who underwent surgery at our medical center between 1997 and 2017. The retrieved information included patient demographics, pathology reports, treatments, and oncological outcomes. Results: 95 consecutive potentially suitable patients were identified. The 78 patients with PNETs who underwent surgery and for whom there was adequate data were included in the analysis. Their mean ± standard deviation age at diagnosis was 57.4 ± 13.4 years (range 20-82), and there were 50 males (64%) and 28 females (36%). 23 patients (30%) had LN metastases (N1). The 2.5- and 5-year disease-free survival (DFS) rates for the entire cohort were 79.5% and 71.8%, respectively, and their 2- and 5-year overall survival (OS) rates were 85.9% and 82.1%, respectively. The optimal value of the LNR was 0.1603, which correlated with the outcome (2-year OS p = 0.002 HR = 13.4 and 5-year DFS p = 0.016 HR = 7.2, respectively, and 5-year OS and 5-year DFS p = 0.004 HR = 9 and p = 0.001 HR = 10.6, respectively). However, the multivariate analysis failed to show that the LNR was an independent prognostic factor in PNETs. Patients with PNETs grade and stage are known key prognostic factors influencing OS and DFS. According to our results, LNR failed to be an independent prognostic factor.
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Ye Z, Chen H, Ji S, Hu Y, Lou X, Zhang W, Jing D, Fan G, Zhang Y, Chen X, Zhuo Q, Chen J, Xu X, Yu X, Xu J, Qin Y, Gao H. MEN1 promotes ferroptosis by inhibiting mTOR-SCD1 axis in pancreatic neuroendocrine tumors. Acta Biochim Biophys Sin (Shanghai) 2022; 54:1599-1609. [PMID: 36604142 PMCID: PMC9828289 DOI: 10.3724/abbs.2022162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Pancreatic neuroendocrine tumor (pNET) is the second most common malignant tumors of the pancreas. Multiple endocrine neoplasia 1 ( MEN1) is the most frequently mutated gene in pNETs and MEN1-encoded protein, menin, is a scaffold protein that interacts with transcription factors and chromatin-modifying proteins to regulate various signaling pathways. However, the role of MEN1 in lipid metabolism has not been studied in pNETs. In this study, we perform targeted metabolomics analysis and find that MEN1 promotes the generation and oxidation of polyunsaturated fat acids (PUFAs). Meanwhile lipid peroxidation is a hallmark of ferroptosis, and we confirm that MEN1 promotes ferroptosis by inhibiting the activation of mTOR signaling which is the central hub of metabolism. We show that stearoyl-coA desaturase (SCD1) is the downstream of MEN1-mTOR signaling and oleic acid (OA), a metabolite of SCD1, recues the lipid peroxidation caused by MEN1 overexpression. The negative correlation between MEN1 and SCD1 is further verified in clinical specimens. Furthermore, we find that BON-1 and QGP-1 cells with MEN1 overexpression are more sensitive to everolimus, a widely used drug in pNETs that targets mTOR signaling. In addition, combined use everolimus with ferroptosis inducer, RSL3, possesses a more powerful ability to kill cells, which may provide a new strategy for the comprehensive therapy of pNETs.
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Affiliation(s)
- Zeng Ye
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Haidi Chen
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Shunrong Ji
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Yuheng Hu
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Xin Lou
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Wuhu Zhang
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Desheng Jing
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Guixiong Fan
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Yue Zhang
- Department of Hepatobiliary and Pancreatic SurgeryThe Third Affiliated Hospital of Soochow UniversityChangzhou213003China
| | - Xuemin Chen
- Department of Hepatobiliary and Pancreatic SurgeryThe Third Affiliated Hospital of Soochow UniversityChangzhou213003China
| | - Qifeng Zhuo
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Jie Chen
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Xiaowu Xu
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Xianjun Yu
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China
| | - Jin Xu
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China,Correspondence address. Tel: +86-21-64175590; (H.G.) / (Y.Q.) / (J.X.) @
| | - Yi Qin
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China,Correspondence address. Tel: +86-21-64175590; (H.G.) / (Y.Q.) / (J.X.) @
| | - Heli Gao
- Center for Neuroendocrine TumorsFudan University Shanghai Cancer CenterShanghai200032China,Department of Pancreatic SurgeryFudan University Shanghai Cancer CenterShanghai200032China,Department of OncologyShanghai Medical CollegeFudan UniversityShanghai200032China,Shanghai Pancreatic Cancer InstituteShanghai200032China,Pancreatic Cancer InstituteFudan UniversityShanghai200032China,Correspondence address. Tel: +86-21-64175590; (H.G.) / (Y.Q.) / (J.X.) @
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