Department of Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Sci Rep. 2020 Aug 6;10(1):13257. doi: 10.1038/s41598-020-70044-8.
Malignant peritoneal mesothelioma (MPeM) is a rare cancer of the mesothelial cells of the peritoneum. Computed tomography (CT) is considered the standard for first-line imaging of MPeM, diagnosis and risk stratification remains challenging. Peritoneal cancer index (PCI), as assessed by CT, is utilized in the prognostic assessment of other malignant intra-abdominal conditions; however, there is limited data concerning the utility of PCI in the diagnosis and workup of MPeM. We studied a retrospective cohort of all patients diagnosed with MPeM from 2000 to 2012 in Finland. CT and magnetic resonance imaging (MRI) were reviewed and scored by an experienced and blinded, board-certified abdominal radiologist. Additional clinical data and outcomes were obtained from Finnish Cancer Registry (FCR), the Workers' Compensations Center (WCC), and Statistics Finland (SF). Abdominal CT or MRI was available for 53 of 90 patients. The median radiographic PCI was 25. PCI score was correlated with overall survival (p = 0.004, Exp(B) = 1.064, 95% CI 1.020-1.110). PCI score ≥ 30 was associated with worse survival (p = 0.002), while PCI ≤ 19 was associated with improved overall survival (p = 0.001). Our study indicates that radiological PCI is prognostic in MPeM and should be assessed during radiographic workup and integrated into clinical decision-making.
恶性腹膜间皮瘤（MPeM）是一种罕见的腹膜间皮细胞癌。计算机断层扫描（CT）被认为是 MPeM 一线成像的标准，但诊断和风险分层仍然具有挑战性。腹膜肿瘤指数（PCI），通过 CT 评估，用于其他恶性腹腔内疾病的预后评估；然而，关于 PCI 在 MPeM 的诊断和评估中的应用，数据有限。我们研究了芬兰 2000 年至 2012 年间所有诊断为 MPeM 的患者的回顾性队列。由一位经验丰富且盲法的、经过委员会认证的腹部放射科医生对 CT 和磁共振成像（MRI）进行了回顾和评分。额外的临床数据和结果来自芬兰癌症登记处（FCR）、工人赔偿中心（WCC）和芬兰统计局（SF）获得。53 名 90 名患者中有腹部 CT 或 MRI。中位数放射性 PCI 为 25。PCI 评分与总生存期相关（p = 0.004，Exp（B）= 1.064，95%CI 1.020-1.110）。PCI 评分≥30 与较差的生存相关（p = 0.002），而 PCI≤19 与总体生存率提高相关（p = 0.001）。我们的研究表明，放射性 PCI 在 MPeM 中具有预后意义，应在影像学检查中进行评估，并纳入临床决策。
