Evaluation the prognosis of pancreatic cancer after radical surgery based on extracellular volume fraction of multiphase CT images
10.3760/cma.j.cn113884-20241219-00384
- VernacularTitle:基于多期CT图像的细胞外体积分数评估胰腺癌根治术预后
- Author:
Jie WANG
1
;
Longjiang CHEN
1
;
Xiaoming WANG
1
Author Information
1. 皖南医学院第一附属医院肝胆外科，芜湖 241000
- Publication Type:Journal Article
- Keywords:
Pancreatic neoplasms;
Extracellular volume fraction;
Multi-phase CT;
Prognosis
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(6):447-452
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of extracellular volume fraction (ECVF) based on multi-phase CT images in the prognosis evaluation after radical resection of pancreatic cancer.Methods:Retrospective analysis of the clinical data of 119 patients with pancreatic ductal adenocarcinoma admitted to the First Affiliated Hospital of Wannan Medical College from January 2015 to December 2023, including 73 males and 46 females, aged 69 (62, 73) years. The clinical data including the patient's gender, age, imaging data, tumor major axis length, carbohydrate antigen (CA) 199, CA125 were collected. Based on multi-phase CT images, the ECVF of patients was calculated and subsequently 119 patients were divided into two groups according to the optimal cut-off value of ECVF: ECVF<0.31 group ( n=63) and ECVF≥0.31 group ( n=56). Postoperative survival information of patients was collected through telephone follow-up. The Kaplan-Meier method was used for survival analysis, and the log-rank test was applied for survival rate comparison. The Cox proportional hazards regression model was employed to analyze the impact of variables on overall survival time. Results:The differences in tumor location, tumor poor differentiation, and tumor major axis between the ECVF<0.31 group and the ECVF≥0.31 group were statistically significant (all P<0.05). The cumulative survival rates at 1, 3, and 5 years post-operation for patients in the ECVF<0.31 group were 34.7%, 10.3%, and 2.6%, respectively, while for patients in the ECVF≥0.31 group, they were 75.0%, 37.0%, and 25.6%, respectively. The cumulative survival rate after radical pancreatic cancer surgery for patients in the ECVF<0.31 group was lower than that for the ECVF≥0.31 group, and the difference is statistically significant ( χ2=24.50, P<0.001). Multivariate Cox analysis revealed that ECVF≥0.31 ( HR=0.25, 95% CI: 0.11-0.57), vascular invasion ( HR=2.43, 95% CI: 1.09-5.44), lymph node metastasis ( HR=3.01, 95% CI: 1.09-8.33), low tumor differentiation ( HR=2.32, 95% CI: 1.10-4.91), and lymphocyte count ≥1.25×10 9/L ( HR=0.31, 95% CI: 0.13-0.73) were risk factors affecting the overall survival of patients with pancreatic ductal adenocarcinoma after radical resection of pancreatic cancer (all P<0.05). Conclusion:ECVF based on multi-phase CT images has a predictive effect on the overall survival of patients with pancreatic ductal adenocarcinoma after radical resection of pancreatic cancer, and ECVF<0.31 is an independent risk factor for a short overall survival.
