文章：

《NETest在小肠神经内分泌肿瘤（Si-NENs）患者中的临床应用：一项“真实世界”研究》

The Clinical Utility of the NETest in Patients with Small Intestinal Neuroendocrine Neoplasms (Si-NENs): A “Real-Life” Study

原文发布日期：10 July 2024

DOI: 10.3390/cancers16142506

类型: Article

开放获取: 是

英文摘要：

Current biomarkers do not adequately predict the behaviour of neuroendocrine neoplasms (NENs). This study assessed the NETest, a multianalyte blood biomarker, in patients with small intestinal NENs (Si-NENs). We studied two patient groups: Group 1: metastatic Si-NENs (n= 102) and Group 2: post-operatively disease-free according to 68Ga-DOTATATE PET (n= 16). NETest scores were ≤20% (normal), 21–40% (low), 41–79% (intermediate), or ≥80% (high). Overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan–Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazards model. In Group 1, the median NETest score was 40% (IQR: 33.3–46.7%). The NETest value (HR: 1.032, 95% CI: 1.003–1.062,p= 0.033) and high-risk NETest category (HR: 10.5, 95% CI: 1.35–81.7,p= 0.025) were independent predictors of PFS, along with presence of lung metastases, CgA levels > 10 × ULN, and tumour growth rate (TGR). Independent predictors of OS were the NETest value (HR: 1.035, 95% CI: 1.005–1.066,p= 0.024) and high-risk NETest category (HR: 15.2, 95% CI: 1.52–151,p= 0.02), along with presence of lung metastases and CgA levels > 10 × ULN. In Group 2, ROC analysis identified an AUC of 0.909 (95% CI: 0.75–0.100) for prediction of local or metastatic recurrence. Blood NETest scores were associated with PFS and OS in patients with metastatic Si-NENs, along with TGR, CgA > 10 × ULN, and presence of lung metastases.

摘要翻译： 

目前生物标志物尚不能充分预测神经内分泌肿瘤（NENs）的生物学行为。本研究评估了多分析物血液生物标志物NETest在小肠神经内分泌肿瘤（Si-NENs）患者中的应用价值。我们研究了两组患者：第一组为转移性Si-NENs患者（n=102），第二组为经68Ga-DOTATATE PET检查确认术后无病灶患者（n=16）。NETest评分分为≤20%（正常）、21–40%（低风险）、41–79%（中风险）或≥80%（高风险）四个等级。采用Kaplan-Meier法评估总生存期（OS）和无进展生存期（PFS），并运用Cox比例风险模型进行单变量及多变量分析。在第一组患者中，NETest评分中位数为40%（四分位距：33.3–46.7%）。NETest数值（风险比：1.032，95%置信区间：1.003–1.062，p=0.033）和高风险NETest分级（风险比：10.5，95%置信区间：1.35–81.7，p=0.025）与肺转移灶存在、嗜铬粒蛋白A水平>10倍正常值上限及肿瘤生长速率共同构成PFS的独立预测因素。OS的独立预测因素包括NETest数值（风险比：1.035，95%置信区间：1.005–1.066，p=0.024）和高风险NETest分级（风险比：15.2，95%置信区间：1.52–151，p=0.02），同时合并肺转移及嗜铬粒蛋白A水平>10倍正常值上限。在第二组患者中，受试者工作特征曲线分析显示NETest预测局部或转移性复发的曲线下面积为0.909（95%置信区间：0.75–1.00）。血液NETest评分与转移性Si-NENs患者的PFS和OS显著相关，其预测价值与肿瘤生长速率、嗜铬粒蛋白A>10倍正常值上限及肺转移灶存在具有协同作用。

原文链接：

The Clinical Utility of the NETest in Patients with Small Intestinal Neuroendocrine Neoplasms (Si-NENs): A “Real-Life” Study