本研究旨在评估68Ga-DOTATOC PET参数在预测胰腺神经内分泌肿瘤（PanNET）患者中DAXX/ATRX表达丧失的作用，并对候选手术的患者进行分析。这项回顾性研究纳入了72例PanNET患者（2018年1月至2022年3月），这些患者接受了68Ga-DOTATOC PET术前分期。影像分析：从原发PanNET进行定性评估和提取SUVmax、SUV平均值、生长抑素受体密度（SRD）和总病变生长抑素受体密度（TLSRD）。收集放射学直径和活组织检查信息（等级、Ki67）。通过免疫组化检测手术标本中DAXX/ATRX的表达丧失情况。使用学生t检验、单变量和多变量 logistic回归和ROC曲线进行分析PET参数对DAXX/ATRX表达丧失的预测价值。其中，42/72例患者的肿瘤为G1级，28/72例患者为G2级，2/72例患者为G3级。7/72例患者的DAXX表达丧失，10/72例患者的ATRX表达丧失，2/72例患者的DAXX/ATRX表达丧失。SRD和TLSRD可预测DAXX表达丧失（p = 0.002，p = 0.018）。通过同时评估SRD和放射学直径，只有SRD保持统计学显著性（多元 logistic回归：p = 0.020，OR = 1.05），提供最佳预测（AUC-ROC = 79.01%；截断值 = 46.96；敏感性 = 77.78%；特异性 = 88.89%）。在对55名具有活组织检查信息的患者进行的子分析中，SRD表现出了提供有用和附加信息的作用（多元 logistic回归：SRD p = 0.007；等级p = 0.040）。SRD在PanNETs中具有预测DAXX表达丧失的作用，在SRD值增加时LoE的概率更高。SRD提供了与生物组织学等级补充/附加的信息，这些方法的联合使用可能支持患者的管理，可以通过术前识别具有更严重疾病的患者。©2023年该作者（专属授权）授权给斯普林格出版公司德国子公司，隶属于斯普林格自然出版集团。

To evaluate the role of 68Ga-DOTATOC PET parameters in predicting DAXX/ATRX loss of expression in patients with Pancreatic neuroendocrine tumors (PanNET) candidate to surgery.This retrospective study included 72 consecutive patients with PanNET (January 2018-March 2022) who underwent to 68Ga-DOTATOC PET for preoperative staging. Image analysis: qualitative assessment and extraction of SUVmax, SUV mean, somatostatin receptor density (SRD), and total lesion somatostatin receptor density (TLSRD) from primary PanNET. Radiological diameter and biopsy information (grade, Ki67) were collected. Loss of expression (LoE) of DAXX/ATRX was assessed by immunohistochemistry on surgical specimen. Student t-test, univariate and multivariate logistic regression and ROC curves have been used to investigate the predictive value of PET parameters on DAXX/ATRX LoE.Forty-two/72 patients had a G1, 28/72 a G2, and 2/72 a G3 PanNET. Seven/72 patients had DAXX LoE, 10/72 ATRX LoE, and 2/72 DAXX/ATRX LoE. SRD and TLSRD could predict DAXX LoE (p = 0.002, p = 0.018, respectively). By evaluating SRD in combination with radiological diameter, only SRD maintained statistical significance (multivariate logistic regression: p = 0.020, OR = 1.05), providing the best prediction (AUC-ROC = 79.01%; cut-off = 46.96; sensitivity = 77.78%; specificity = 88.89%). In the sub-analysis performed on 55 patients with biopsy availability, SRD demonstrated its role in providing useful and additional information (multivariate logistic regression: SRD p = 0.007; grade p = 0.040).SRD has a predictive role on DAXX LoE in PanNETs, with higher probability of LoE at increasing SRD values. SRD provides complementary/additional information to grade assessed on biopsy material, and the combined use of these approaches might support patients' management by preoperatively identifying subjects with more aggressive diseases.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.