Kassardjian Ari, Stanzione Nicholas, Wang Hanlin L
From the Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Pancreas. 2019 Feb;48(2):223-227. doi: 10.1097/MPA.0000000000001233.
Tumor size has been shown to be a strong predictor of patient survival in pancreatic ductal adenocarcinoma (PDAC). The aims of this study were to assess the consistency of preoperative imaging and gross examination for PDAC tumor size measurement and to evaluate the impact on T and overall tumor staging when size measurements by imaging and gross examination were different.
Patients diagnosed with PDAC who underwent pancreaticoduodenectomy or distal pancreatectomy from 2007 to 2017 were retrospectively reviewed. A total of 268 cases were included.
Imaging studies underestimated tumor size in comparison with gross examination. Staging the tumors based on imaging size using the eighth edition American Joint Committee on Cancer resulted in an altered T stage in 106 cases (39.6%). There was no T-stage change in the remaining 162 cases (60.4%) despite the presence of variable size discrepancies (0.1-1.7 cm). When nodal metastases were also considered, there was no change in the overall tumor stage in most cases.
Although discrepancies exist between tumor size measurements by imaging modalities and gross examination, which may result in an altered T stage in a substantial number of cases, the overall tumor stage is only rarely altered.
肿瘤大小已被证明是胰腺导管腺癌（PDAC）患者生存的有力预测指标。本研究的目的是评估术前影像学检查和大体检查在测量PDAC肿瘤大小方面的一致性，并评估当影像学检查和大体检查测量的肿瘤大小不同时对T分期和总体肿瘤分期的影响。
回顾性分析2007年至2017年接受胰十二指肠切除术或胰腺远端切除术的PDAC患者。共纳入268例病例。
与大体检查相比，影像学检查低估了肿瘤大小。根据美国癌症联合委员会第八版基于影像学大小对肿瘤进行分期，导致106例（39.6%）患者的T分期发生改变。其余162例（60.4%）患者尽管存在大小差异（0.1 - 1.7 cm），但T分期未发生变化。当同时考虑淋巴结转移时，大多数病例的总体肿瘤分期没有变化。
尽管影像学检查和大体检查在肿瘤大小测量上存在差异，这可能导致相当数量病例的T分期改变，但总体肿瘤分期很少改变。
