Pancreatic fibrosis by extracellular volume fraction using Contrast-enhanced computed tomography and relationship with pancreatic cancer
Pancreatic fibrosis by extracellular volume fraction using Contrast-enhanced computed tomography and relationship with pancreatic cancer
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DOI：
10.1016/j.ejrad.2022.110522
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发表时间：
2022-09-13
影响因子：
3.3
通讯作者：
Tomiyama, Noriyuki
中科院分区：
文献类型：
--
作者：
Fukui, Hideyuki;Onishi, Hiromitsu;Tomiyama, Noriyuki
目的：本研究旨在评估胰腺纤维化与胰腺癌之间的关系，并探讨胰腺纤维化与胰腺癌的关系。方法：本研究包括88例连续的患者，（48名男性，40名女性;中位年龄69岁;范围17-89岁）; 47名患有胰腺癌，41名患有其他疾病。对52例胰腺纤维化进行了病理学评价。使用2 μ m厚Azan染色切片，在切除残端的非肿瘤胰腺组织中使用图像分析软件定量组织学胰腺纤维化分数。两名委员会认证的放射科医生在估计的横断线处测量胰腺实质中的ECV。结果：胰腺组织学纤维化分数与ECV值呈显著正相关（r = 0.64，P <0.01），ECV值与胰腺组织学纤维化分数呈显著负相关（r = 0.64，P < 0.01）。胰腺癌患者ECV评估的胰腺纤维化程度高于其他患者（P < 0.01）。在受试者工作特征曲线分析中，ECV对胰腺癌的诊断准确性良好（截断值32.8%，敏感性61.0%，特异性85.1%）。多因素分析显示ECV是胰腺癌的独立危险因素（OR = 1.16; P < 0.01）。结论：细胞外容积分数与胰腺组织学纤维化分数密切相关，而胰腺组织学纤维化分数与胰腺癌独立相关。因此，细胞外容积分数是反映胰腺纤维化进展的成像生物标志物，可能有助于预测胰腺癌的发展，但仍需进一步研究。
Purpose: This study aimed to assess the relationship between pancreatic fibrosis measured by the extracellular volume fraction (ECV) using contrast-enhanced computed tomography (CT) and the histologic pancreatic fibrosis fraction and investigate the relationship between pancreatic fibrosis and pancreatic cancer.Method: The study included 88 consecutive patients (48 males, 40 females; median age, 69 years; range, 17-89 years); 47 had pancreatic cancer, and 41 had other diseases. Fifty-two cases were evaluated pathologically for pancreatic fibrosis. The histologic pancreatic fibrosis fraction was quantified using image analysis software in nontumorous pancreatic tissue at the resection stump using 2 -mu m-thick Azan-stained slides. Two board-certified radiologists measured ECV in the pancreatic parenchyma at an estimated transection line. The correlation be-tween histologic pancreatic fibrosis fraction and ECV was investigated, and whether the ECV value could be used as a biomarker for pancreatic cancer was investigated.Results: The histologic pancreatic fibrosis fraction was significantly correlated with the ECV (r = 0.64, P < 0.01). Pancreatic fibrosis evaluated by ECV was higher in pancreatic cancer patients than in other patients (P < 0.01). On receiver-operating characteristic curve analysis, the ECV had good diagnostic accuracy for the development of pancreatic cancer (cut-off value 32.8%; sensitivity 61.0%, specificity 85.1%). ECV was identified on multi-variate analysis as an independent risk factor for pancreatic cancer (odds ratio 1.16; P < 0.01).Conclusions: Extracellular volume fraction was strongly related to the histologic pancreatic fibrosis fraction, which was independently associated with pancreatic cancer. Thus, extracellular volume fraction is an imaging biomarker that reflects the progression of pancreatic fibrosis and may potentially help predict the development of pancreatic cancer, although further investigation will be needed.