Kanamathareddy Harsha Veena, Lakhani Aisha, Augustine Antony, Thanikaivelu Sonia, Eapen Anu, John Reetu, Simon Betty, Masih Dipti, Sarvarasan Inian, Singh Ashish, Chandramohan Anuradha
Department of Radiology, Christian Medical College, Vellore, 632004, India.
Department of General Pathology, Christian Medical College, Vellore, 632004, India.
Jpn J Radiol. 2025 Jan;43(1):58-67. doi: 10.1007/s11604-024-01644-x. Epub 2024 Aug 29.
To study the prevalence of extramural vascular invasion (EMVI) in patients with gastric adenocarcinoma (GA) and its association with other prognostic factors.
In this retrospective study, consecutive patients with GA who underwent staging CT between January 2021 and December 2022 were included. Two radiologists reviewed the staging CT for EMVI and its grade and documented tumor location, thickness, and TNM stage. Grade 3 and 4 EMVI were reported as ct-EMVI positive and the rest as negative. Similar findings were documented on restaging CT following neoadjuvant chemotherapy (NAC) when available. ct-EMVI was compared with imaging findings on staging and restaging CT, staging laparoscopy findings, peritoneal fluid cytology, and surgical histopathology findings.
A total of 191 patients (140 males, 51 females) with a mean age of 53 ± 9 years (range 23-93 years) were included. 82.2% had poorly differentiated GA and 17.8% had well/moderately differentiated GA. The majority (95.9%) had T3 (n = 34) and T4 (n = 118) disease on baseline CT. The prevalence of ct-EMVI on staging CT was 65% (n = 124), and 34% and 86% among the T3 and T4 GA, respectively. There was a significant association between ct-EMVI and, tumor thickness, tumor extent, ct-T, N, M stages, and especially peritoneal, lymph nodes, and liver metastases and response to NAC (p < 0.05).
EMVI is seen commonly in staging CT of advanced gastric cancer patients and is significantly associated with TNM stage, peritoneal metastases, and response to neoadjuvant chemotherapy. Thus, ct-EMVI is a significant prognostic imaging biomarker in GA. IRB min no: 15713.
研究胃腺癌（GA）患者壁外血管侵犯（EMVI）的发生率及其与其他预后因素的关系。
在这项回顾性研究中，纳入了2021年1月至2022年12月期间连续接受分期CT检查的GA患者。两名放射科医生对分期CT进行EMVI及其分级评估，并记录肿瘤位置、厚度和TNM分期。3级和4级EMVI报告为ct-EMVI阳性，其余为阴性。如有新辅助化疗（NAC）后的再分期CT，记录类似结果。将ct-EMVI与分期和再分期CT的影像学表现、分期腹腔镜检查结果、腹水细胞学检查结果及手术组织病理学检查结果进行比较。
共纳入191例患者（男性140例，女性51例），平均年龄53±9岁（范围23 - 93岁）。82.2%为低分化GA，17.8%为高/中分化GA。大多数（95.9%）患者在基线CT上表现为T3（n = 34）和T4（n = 118）期疾病。分期CT上ct-EMVI的发生率为65%（n = 124），T3和T4期GA中分别为34%和86%。ct-EMVI与肿瘤厚度、肿瘤范围、ct-T、N、M分期，尤其是腹膜、淋巴结和肝转移以及对NAC的反应之间存在显著关联（p < 0.05）。
EMVI在晚期胃癌患者的分期CT中常见，且与TNM分期、腹膜转移及新辅助化疗反应显著相关。因此，ct-EMVI是GA中一个重要的预后影像学生物标志物。机构审查委员会最小编号：15713。
