Assessment of the predictive value of ultrasound imaging characteristics combined with clinical indicators for the prognosis of pancreatic ductal adenocarcinoma
10.3760/cma.j.cn112150-20241025-00850
- VernacularTitle:超声影像特征联合临床指标对胰腺导管腺癌预后的预测价值评估
- Author:
Hua LIANG
1
;
Ke LYU
;
Yang GUI
;
Xueqi CHEN
;
Tianjiao CHEN
;
Li TAN
;
Menghua DAI
;
Weibin WANG
;
Junchao GUO
;
Qiang XU
;
Huanyu WANG
;
Xiaoyi YAN
;
Wanying JIA
;
Yuming SHAO
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院超声医学科，北京100730
- Publication Type:Journal Article
- Keywords:
Pancreatic ductal adenocarcinoma;
Contrast-enhanced ultrasound;
Carbohydrate antigen 19-9;
Prognosis;
Cohort studies
- From:
Chinese Journal of Preventive Medicine
2025;59(10):1748-1755
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of ultrasound imaging characteristics combined with clinical indicators in assessing the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC).Methods:A retrospective analysis was conducted for patients who underwent pancreatic contrast-enhanced ultrasound (CEUS) from September 2017 to October 2023 at Peking Union Medical College Hospital and were diagnosed with PDAC based on pathological findings. Various parameters were recorded, including CA19-9 levels, tumor size, location, morphologic features, echogenicity, presence of internal cystic components, dilatation of the main pancreatic duct, peripheral vascular invasion, CEUS characteristics, presence or absence of liver metastasis, and treatment methods. In April 2024, patient survival information was obtained through telephone follow-up or review of medical records. Based on the results of the cox regression model analysis, a nomogram model of the risk of death was developed. The receiver operating characteristic (ROC) curves were applied to evaluate the predictive efficacy of the model. The calibration curves were plotted to evaluate the accuracy of the model, and clinical decision curves were used to evaluate the clinical benefit of the model.Results:This study included a total of 207 patients with PDAC. As of April 2024, 71 patients were alive and 136 died, with a median survival time of 14 months (95% CI: 12 -17). Multivariate analysis confirmed that the elevated CA19-9 ( HR=1.689, 95% CI: 1.102-2.588), tumor size >4 cm ( HR=1.641, 95% CI: 1.159-2.322), taller-than-wide shapes ( HR=1.450, 95% CI: 1.019-2.065), incomplete hypo-enhancement ( HR=1.618, 95% CI: 1.100-2.380), and liver metastasis ( HR=1.687, 95% CI: 1.175-2.423) were independent risk factors for survival in patients with PDAC. A nomogram model was further constructed for 6-month, 12-month and 3-year survival of patients with PDAC. The areas under the ROC curve were 0.679, 0.705 and 0.815, respectively. The calibration curves suggested that the model was more accurate, and the clinical decision curves showed that the model had a better clinical benefit. Conclusion:The combined use of ultrasound imaging characteristics and clinical indicators could effectively predict the prognosis of PDAC patients. Specifically, tumor size >4 cm, taller-than-wide shapes, incomplete hypo-enhancement, elevated CA19-9, and the presence of liver metastasis are correlated with poorer survival outcomes. The nomogram model constructed on the basis of these factors can be used to assess the survival of patients with PDAC.
