Mao Yingfan, Zhu Yong, Qiu Yudong, Kong Weiwei, Mao Liang, Zhou Qun, Chen Jun, He Jian
Department of Radiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
Department of Radiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of the Nanjing University of Chinese Medicine, Nanjing 210008, China.
Quant Imaging Med Surg. 2019 Feb;9(2):219-229. doi: 10.21037/qims.2018.12.11.
To investigate the differences of clinicopathological characteristics and computed tomography (CT) features between intrahepatic cholangiocarcinomas (ICC) with and without peritumoral Glisson's sheath invasion (PGSI), and to construct a nomogram to predict PGSI of ICCs preoperatively.
The clinicopathological characteristics and CT features of 84 ICCs were retrospectively analyzed and compared between ICCs with (30/84, 35.7%) and without PGSI (54/84, 64.3%). Multivariate logistic regression analysis was used to identify preoperative independent predictors of PGSI in ICCs. A nomogram was constructed to predict PGSI preoperatively.
ICCs with and without PGSI differed significantly in the presence of abdominal pain, serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels, TNM and T stages, tumor location, intratumoral calcifications, intrahepatic bile duct dilatation, intrahepatic bile duct calculus, morphologic type and dynamic enhancement pattern on CT images (all P<0.05). Abdominal pain, serum CEA level, intrahepatic bile duct dilatation, and morphologic type were independent predictors of PGSI in ICCs. A nomogram based on those predictors was constructed to predict PGSI preoperatively with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.908 (P<0.001).
Clinicopathological characteristics and CT features differed significantly between ICCs with and without PGSI. A nomogram including abdominal pain, serum CEA level, intrahepatic bile duct dilatation, and morphologic type could predict PGSI accurately.
探讨有和无瘤周肝门部Glisson鞘侵犯（PGSI）的肝内胆管癌（ICC）的临床病理特征及计算机断层扫描（CT）特征差异，并构建术前预测ICC的PGSI的列线图。
回顾性分析84例ICC的临床病理特征及CT特征，并对有PGSI（30/84，35.7%）和无PGSI（54/84，64.3%）的ICC进行比较。采用多因素logistic回归分析确定ICC中PGSI的术前独立预测因素。构建术前预测PGSI的列线图。
有和无PGSI的ICC在腹痛、血清癌胚抗原（CEA）和糖类抗原19-9（CA19-9）水平、TNM和T分期、肿瘤位置、瘤内钙化、肝内胆管扩张、肝内胆管结石、形态学类型及CT图像上的动态增强模式方面均有显著差异（均P<0.05）。腹痛、血清CEA水平、肝内胆管扩张及形态学类型是ICC中PGSI的独立预测因素。基于这些预测因素构建了术前预测PGSI的列线图，其受试者工作特征（ROC）曲线下面积（AUC）为0.908（P<0.001）。
有和无PGSI的ICC的临床病理特征及CT特征有显著差异。包含腹痛、血清CEA水平、肝内胆管扩张及形态学类型的列线图可准确预测PGSI。
