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基于 CT 和 MRI 的影像学特征预测肝内胆管细胞癌患者预后的单中心研究和荟萃分析。

Imaging features based on CT and MRI for predicting prognosis of patients with intrahepatic cholangiocarcinoma: a single-center study and meta-analysis.

机构信息

Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People's Republic of China.

Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, 300 Guangzhou Road, Nanjing, 210029, People's Republic of China.

出版信息

Cancer Imaging. 2023 Jun 7;23(1):56. doi: 10.1186/s40644-023-00576-5.

Abstract

BACKGROUND

To evaluate the prognostic role of imaging features based on CT and MRI in intrahepatic cholangiocarcinoma (ICC).

METHODS

Two hundred and four patients from a single-center database who underwent radical ICC surgery from 2010 to 2019 were enrolled in the study. Cox proportional hazard model was used for survival analysis of imaging features. A meta-analysis was performed to determine imaging features that predict overall survival (OS) and event-free survival (EFS) in ICC.

RESULTS

In the CT group of the retrospective cohort, tumor multiplicity, infiltrative tumor margin, lymph node metastasis, enhancement pattern in hepatic arterial phase and tumor necrosis correlated with poorer EFS and OS; moreover, enhancing capsules, high carcinoembryonic antigen levels contributed to poor OS. In the MRI group, tumor multiplicity and enhancement pattern were prognostic factors for OS; tumor multiplicity and enhancement pattern resulted in poor EFS. A total of 13 articles containing 1822 patients with ICC were enrolled in the adjusted hazard ratios meta-analysis. The results showed that enhancement pattern and infiltrative tumor margin were predictors of OS and EFS, whereas bile duct invasion was a predictor of OS.

CONCLUSIONS

Arterial enhancement patterns and tumor margin status were associated with both OS and EFS of ICC patients following resection.

摘要

背景

评估基于 CT 和 MRI 的影像学特征在肝内胆管癌(ICC)中的预后作用。

方法

本研究纳入了 2010 年至 2019 年期间在单中心数据库中接受根治性 ICC 手术的 240 例患者。采用 Cox 比例风险模型对影像学特征进行生存分析。进行荟萃分析以确定预测 ICC 总生存率(OS)和无事件生存率(EFS)的影像学特征。

结果

在回顾性队列的 CT 组中,肿瘤多发、浸润性肿瘤边缘、淋巴结转移、肝动脉期强化模式和肿瘤坏死与较差的 EFS 和 OS 相关;此外,强化包膜、高癌胚抗原水平与较差的 OS 相关。在 MRI 组中,肿瘤多发和强化模式是 OS 的预后因素;肿瘤多发和强化模式导致 EFS 较差。共有 13 篇包含 1822 例 ICC 患者的文章被纳入调整后的危险比荟萃分析。结果表明,强化模式和浸润性肿瘤边缘是 ICC 患者术后 OS 和 EFS 的预测因素,而胆管侵犯是 OS 的预测因素。

结论

动脉强化模式和肿瘤边缘状态与 ICC 患者的 OS 和 EFS 均相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/687d/10245452/aaa8d681a210/40644_2023_576_Fig1_HTML.jpg

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