Fukukura Yoshihiko, Takumi Koji, Higashi Michiyo, Shinchi Hiroyuki, Kamimura Kiyohisa, Yoneyama Tomohide, Tateyama Akihiro
Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan.
Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan.
Eur J Radiol. 2014 Apr;83(4):612-9. doi: 10.1016/j.ejrad.2013.12.016. Epub 2013 Dec 27.
To determine whether contrast enhancement of CT and apparent diffusion coefficient on diffusion-weighted MR imaging are important parameters that can predict outcomes for patients with pancreatic ductal adenocarcinoma.
Ninety-two patients with histologically confirmed pancreatic ductal adenocarcinoma who underwent quadriphasic CT (including unenhanced, pancreatic parenchymal, portal venous and delayed phases) and fat-suppressed single-shot echo-planar diffusion-weighted MR imaging at 3.0 T were retrospectively analyzed to investigate prognostic factors. Overall survival curves were drawn using the Kaplan-Meier method. Effects on survival of variables including age, sex, tumor location, tumor size, TNM stage, carbohydrate antigen 19-9, carcinoembryonic antigen, treatment, tumor contrast enhancement and apparent diffusion coefficient values were analyzed in univariate analysis using the log-rank test. Variables were analyzed in multivariate analyses using the Cox proportional hazards regression model.
Median survival for the entire patient population was 18.2 months. Higher contrast enhancement during all phases was associated with significantly longer overall survival (P<0.001 for all phases). The difference in overall survival between groups divided by median apparent diffusion coefficient value was not significant (P=0.672). TNM stage (P=0.026) and tumor contrast enhancement on CT (P=0.027) were significantly related to survival in multivariate analysis.
Poor enhancement of pancreatic adenocarcinomas on enhanced CT is associated with reduced patient survival.
确定CT对比增强及扩散加权磁共振成像中的表观扩散系数是否为可预测胰腺导管腺癌患者预后的重要参数。
回顾性分析92例经组织学证实为胰腺导管腺癌的患者，这些患者均接受了四期CT检查（包括平扫、胰腺实质期、门静脉期和延迟期）以及3.0 T场强下的脂肪抑制单次激发回波平面扩散加权磁共振成像，以研究预后因素。采用Kaplan-Meier法绘制总生存曲线。在单因素分析中，使用对数秩检验分析年龄、性别、肿瘤位置、肿瘤大小、TNM分期、糖类抗原19-9、癌胚抗原、治疗、肿瘤对比增强及表观扩散系数值等变量对生存的影响。在多因素分析中，使用Cox比例风险回归模型分析变量。
整个患者群体的中位生存期为18.2个月。各期较高的对比增强均与显著更长的总生存期相关（各期P<0.001）。根据中位表观扩散系数值分组的各组间总生存期差异无统计学意义（P=0.672）。在多因素分析中，TNM分期（P=0.026）和CT上的肿瘤对比增强（P=0.027）与生存显著相关。
增强CT上胰腺腺癌强化不佳与患者生存期缩短相关。
