对比增强ct衍生的细胞外体积分数预测胰腺癌术后患者的生存

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-27 DOI:10.1016/j.ejrad.2025.112273

Shuai Ming , Wuyang Zhang , Min Wang , Jingyu Li , Dan Shi , Bin Wang , Mengru Li , Yadi Zhang , Chenglin Zhu , Aiyun Sun , Wei Wei

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引用次数: 0

摘要

目的评价对比增强计算机断层扫描（CECT）所得细胞外体积（ECV）分数对可切除胰导管腺癌（PDAC）生存预后的预测价值。方法研究队列共包括166例可切除的PDAC患者，这些患者在2018年1月至2021年3月期间接受了CECT手术切除。肿瘤CT衍生的ECV分数由未增强和平衡期CT图像计算。临床因素、CECT参数和肿瘤ct衍生的ECV分数对总生存期（OS）和无进展生存期（PFS）的影响采用Cox比例风险模型进行单因素和多因素分析。为了验证ECV的可靠性，我们对一部分患者的手术切除标本进行了马松三色染色，以量化瘤内胶原含量。Pearson相关性分析ct衍生ECV与胶原蛋白比值（CR）的关系。结果ct衍生的ECV分数中位数为32%（21% ~ 41%）。增加肿瘤ct衍生的ECV分数与OS和PFS的积极影响相关。年龄和ct衍生的ECV分数是OS的独立预测因子(p = 0.012；p = 0.001)。肿瘤大小和ct衍生的ECV分数是PFS的独立预测因子(p = 0.016；p = 0.001)。ECV与CR呈强相关(R2 = 0.860, p <；0.001)。结论ct衍生的ECV分数是预测可切除PDAC患者生存的无创生物标志物。

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Contrast-enhanced CT-Derived extracellular volume fraction predicts survival in postoperative pancreatic cancer patients

Objective

To evaluate the prognostic value of extracellular volume (ECV) fraction derived from contrast-enhanced computed tomography (CECT) in predicting survival outcomes of resectable pancreatic ductal adenocarcinoma (PDAC).

Methods

The study cohort included a total of 166 patients with resectable PDAC who underwent CECT before operative excision between Jan 2018 and Mar 2021. Tumor CT-derived ECV fractions were calculated from unenhanced and equilibrium-phase CT images. The effects of clinical factors, CECT parameters, and tumor CT-derived ECV fractions on overall survival (OS) and progression-free survival (PFS) were assessed by univariate and multivariate analyses using Cox proportional hazards models. In order to verify the reliability of ECV, Masson’s Trichrome staining was performed on surgical resection specimens from a subset of patients to quantify intratumoral collagen content. Pearson correlation analyzed relationships between CT-derived ECV and collagen ratio (CR).

Results

The median value of CT-derived ECV fraction was 32 % (21 % − 41 %) . Increasing tumor CT-derived ECV fractions were associated with a positive effect on OS and PFS. Age and CT-derived ECV fraction was an independent predictor of OS (p = 0.012; p = 0.001) in patients with postoperative PDAC. Tumor size and CT-derived ECV fraction was an independent predictor of PFS (p = 0.016; p = 0.001) in patients with postoperative PDAC. ECV strongly correlated with CR (R² = 0.860, p < 0.001).

Conclusion

CT-derived ECV fraction is a noninvasive biomarker for predicting survival in resectable PDAC.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.