Application value of enhanced CT scanning combined with serum CgA level in differential diagnosis and pathological grade evaluation of gastrointestinal neuroendocrine tumors

ZHANG Xianhui; SI Yuan; QI Kangda; YANG Jiawei; HAO Ruichao

doi:10.20258/j.cnki.1006-9011.2025.06.016

Abstract：Objective To evaluate the value of CT enhanced scanning combined with serum chromogranin A(CgA)level in the differential diagnosis and pathological grading of gastrointestinal neuroendocrine tumors(GINEN).Methods Seventy GINEN patients(GINEN group)were selected and divided into G1,G2 and G3,with 28 cases in G1 and G2,and 42 cases in G3 according to cell proliferation activity and mitosis.Meanwhile,another 30 patients with gastrointestinal lymphoma(PGIL group)were selected.The subjects underwent enhanced CT scan and serum CgA detection before surgery.The characteristics of enhanced CT scan and serum CgA level were compared between the two groups,and the value of enhanced CT scan characteris-tics and serum CgA level in the differential diagnosis of GINEN was analyzed by receiver operating characteristic(ROC)curve.The characteristics of enhanced CT scan and serum CgA level of GINEN patients with different pathological grades were com-pared,and the application value of enhanced CT scan characteristics and serum CgA level in the evaluation of pathological grades of GINEN was analyzed by ROC curve.Results There were significant differences in lesion size,number,enhance-ment uniformity and blood CgA level between the two groups(all P<0.05).ROC curve analysis showed that the AUC of CT en-hanced scanning feature combined with serum CgA level in the differential diagnosis of GINEN was significantly higher than that of CT enhanced scanning feature combined with serum CgA level alone(P<0.05).The proportion of lesion morphology and inva-sive type,the proportion of lesion size≥6.5 cm2,the proportion of cystic lesion,ulcer or necrosis,the proportion of lymph node metastasis and the level of serum CgA in G1 and G2 GINEN patients were lower than those in G3 GINEN patients(P<0.05).ROC curve analysis showed that the AUC of G3 in GINEN pathological grade was significantly higher than that of G3 in GINEN pathological grade evaluated by the enhanced CT scanning features and serum CgA level alone(P<0.05).Conclusion En-hanced CT scan and serum CgA level have certain application value in the differential diagnosis and pathological grading evalua-tion of GINEN,and the combination of the two can improve its application value.