Rim Enhancement on Contrast-Enhanced CT as a Predictor of Prognosis in Patients with Pancreatic Ductal Adenocarcinoma
Rim Enhancement on Contrast-Enhanced CT as a Predictor of Prognosis in Patients with Pancreatic Ductal Adenocarcinoma
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DOI：
10.3390/diagnostics14080782
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发表时间：
2024-04
期刊：
影响因子：
3.6
通讯作者：
Takeru Yamaguchi;K. Sofue;E. Ueshima;Naoki Sugiyama;Shinji Yabe;Yoshiko Ueno;A. Masuda;H. Toyama;T. Kodama;Masato Komatsu;Masatoshi Hori;Takamichi Murakami
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作者：
Takeru Yamaguchi;K. Sofue;E. Ueshima;Naoki Sugiyama;Shinji Yabe;Yoshiko Ueno;A. Masuda;H. Toyama;T. Kodama;Masato Komatsu;Masatoshi Hori;Takamichi Murakami
本研究探讨了造影增强CT （CECT）边缘增强等影像学特征在预测胰腺导管腺癌（PDAC）预后中的应用。本回顾性研究包括158例病理证实的PDAC患者（84例男性，平均年龄68岁）。以下影像学特征由两名放射科医生在CECT上进行评估：肿瘤大小、肿瘤衰减和边缘增强的存在。进行Cox比例风险分析，以确定预测无病生存期（DFS）和总生存期（OS）的影像学和临床病理特征。病理特征与边缘强化的存在进行比较。158例患者中，106例（67%）行根治性手术（手术组），52例（33%）行保守治疗（非手术组）。边缘增强在非手术组比手术组更常见（44%比20%；p < 0.001）。手术组边缘增强与较短的DFS和OS有显著相关性(风险比分别为3.03和2.99；p < 0.001和p = 0.003)，而肿瘤大小与较短的OS有显著相关（每增加1 mm的HR为1.08,p < 0.001）。边缘增强的pdac与较高的组织学肿瘤分级显著相关（p < 0.001）。CECT边缘增强的PDAC可以预测较差的预后和更严重的肿瘤分级。
This study investigated the utility of imaging features, such as rim enhancement on contrast-enhanced CT (CECT), in predicting the prognosis of pancreatic ductal adenocarcinoma (PDAC). This retrospective study included 158 patients (84 men; mean age, 68 years) with pathologically confirmed PDAC. The following imaging features were evaluated on CECT by two radiologists: tumor size, tumor attenuation, and the presence of rim enhancement. Cox proportional hazards analysis was performed to identify the imaging and clinicopathological features for predicting disease-free survival (DFS) and overall survival (OS). Pathological features were compared with the presence of rim enhancement. Among the 158 patients, 106 (67%) underwent curative surgery (surgery group) and 52 (33%) received conservative treatment (non-surgery group). Rim enhancement was observed more frequently in the non-surgery group than in the surgery group (44% vs. 20%; p < 0.001). Rim enhancement showed significant associations with shorter DFS and OS in the surgery group (hazard ratios (HRs), 3.03 and 2.99; p < 0.001 and p = 0.003, respectively), whereas tumor size showed significant associations with shorter OS (HR per 1 mm increase, 1.08; p < 0.001). PDACs with rim enhancement showed significant associations with higher histological tumor grades (p < 0.001). PDAC with rim enhancement on CECT could predict poorer prognosis and more aggressive tumor grades.