Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Abdom Radiol (NY). 2021 Feb;46(2):623-635. doi: 10.1007/s00261-020-02676-3. Epub 2020 Aug 1.
To investigate the relationship between imaging findings and S100A4 overexpression in pancreatic ductal adenocarcinoma (PDAC) and to determine imaging biomarkers of S100A4 overexpression from whole-tumor evaluation with MRI and texture analysis.
A total of 60 patients with pathologically confirmed PDAC were included in the study. All patients underwent preoperative abdominal contrast-enhanced MRI examination with Magnetom Aera (Siemens Healthcare, Germany, 1.5 T) at our institute. Whole-tumor evaluation including texture analysis was performed. Sections of specimens were reviewed, and the S100A4 expression status was quantitatively evaluated. Univariate and multivariate logistic regression analyses were conducted to find imaging biomarkers that could predict S100A4 overexpression.
Twenty-four tumors (40.0%) had negative results for S100A4 overexpression, and 36 tumors (60.0%) exhibited overexpression. After univariate and multivariate analysis, distal pancreatic duct dilatation, TWI_10th percentile and the enhancement rate difference between delayed phase (DP) and portal venous phase (PVP) were identified to predict S100A4 overexpression in PDAC independently (p = 0.009, 0.012 and 0.044), with odds ratios (ORs) of 0.102, 0.139 and 4.645, respectively. The area under the ROC curve (AUC) values were 0.715, 0.707 and 0.691. The AUC value of the proposed model was 0.877 with a sensitivity of 80.6% and specificity of 75.0%.
A model including distal pancreatic duct dilatation, TWI_10th percentile and the enhancement rate difference between the DP and PVP could predict S100A4 overexpression in PDAC as imaging biomarkers.
研究胰腺导管腺癌（PDAC）中影像学表现与 S100A4 过表达的关系，并通过 MRI 全瘤评估及纹理分析确定 S100A4 过表达的影像学生物标志物。
本研究纳入了 60 例经病理证实的 PDAC 患者。所有患者均在我院行术前腹部增强 MRI 检查（德国西门子医疗公司 Magnetom Aera，1.5 T）。对全瘤进行评估，包括纹理分析。对标本切片进行复查，并对 S100A4 的表达状态进行定量评估。采用单因素和多因素逻辑回归分析寻找能预测 S100A4 过表达的影像学标志物。
24 例肿瘤（40.0%）的 S100A4 过表达结果为阴性，36 例肿瘤（60.0%）为过表达。单因素和多因素分析后，远端胰管扩张、TWI_10th 百分位数和延迟期（DP）与门静脉期（PVP）强化率差值被确定为可独立预测 PDAC 中 S100A4 过表达的影像学标志物（p=0.009、0.012 和 0.044），其优势比（OR）分别为 0.102、0.139 和 4.645，ROC 曲线下面积（AUC）值分别为 0.715、0.707 和 0.691。提出的模型 AUC 值为 0.877，其敏感性为 80.6%，特异性为 75.0%。
包括远端胰管扩张、TWI_10th 百分位数和 DP 与 PVP 强化率差值的模型可作为预测 PDAC 中 S100A4 过表达的影像学生物标志物。
