Yasue Tomomi, Ashida Reiko, Takada Ryoji, Ikezawa Kenji, Ohkawa Kazuyoshi, Nagata Shigenori, Teshima Teruki, Akita Hirofumi, Takahashi Hidenori, Doki Yuichiro, Eguchi Hidetoshi
Department of Clinical Laboratory, Osaka Habikino Medical Center, Habikino City, Osaka, 583-8588, Japan.
Department of Gastroenterological Surgery, The University of Osaka Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 537-8511, Japan.
BMC Gastroenterol. 2025 Jul 19;25(1):526. doi: 10.1186/s12876-025-04108-2.
Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) has promising potential in the diagnosis of pancreatic tumors, assessment of fibrosis, and prediction of chemotherapy efficacy. We hypothesize that radiation therapy might reduce variations in chemotherapeutic efficacy caused by fibrosis-induced blood flow disparities, as we explored the relationship between CH-EUS patterns and the efficacy of neoadjuvant chemoradiotherapy (NACRT) in resectable pancreatic cancer (PC).
Patients with resectable PC who underwent CH-EUS followed by NACRT were retrospectively analyzed. The CH-EUS enhancement pattern was evaluated in the vascular and perfusion phases and classified according to vascularity: Group A, hypovascular in both phases; Group B, isovascular and hypovascular in the vascular and perfusion phases, respectively; and Group C, isovascular in both phases. The relationships between the CH-EUS vascular pattern and the histological response according to the Evans classification to NACRT, recurrence-free survival (RFS) and overall survival (OS) were evaluated.
Of the 48 enrolled patients, 31, 11, and 6 were classified into Groups A, B, and C, respectively. There was no significant difference in histopathological differentiation (p = 0.314) or the efficacy of NACRT (p = 0.282) among the groups. In addition, there was no significant difference between the groups in terms of median RFS or OS, although it was longer than previously reported.
The histopathological efficacy of NACRT for resectable PC did not differ significantly on the basis of enhancement pattern observed on CH-EUS. NACRT may provide additional therapeutic benefit independent of blood flow considerations.
对比增强谐波内镜超声（CH-EUS）在胰腺肿瘤诊断、纤维化评估及化疗疗效预测方面具有广阔前景。我们推测放射治疗可能会减少由纤维化引起的血流差异所导致的化疗疗效差异，为此我们探讨了CH-EUS模式与可切除胰腺癌（PC）新辅助放化疗（NACRT）疗效之间的关系。
对接受CH-EUS检查后进行NACRT的可切除PC患者进行回顾性分析。在血管期和灌注期评估CH-EUS增强模式，并根据血管情况进行分类：A组，两期均为低血供；B组，血管期等血供、灌注期低血供；C组，两期均为等血供。评估CH-EUS血管模式与NACRT的Evans分类组织学反应、无复发生存期（RFS）和总生存期（OS）之间的关系。
48例入组患者中，分别有31例、11例和6例被分为A组、B组和C组。各组间组织病理学分化（p = 0.314）或NACRT疗效（p = 0.282）无显著差异。此外，各组间中位RFS或OS无显著差异，尽管其比先前报道的更长。
基于CH-EUS观察到的增强模式，NACRT对可切除PC的组织病理学疗效无显著差异。NACRT可能提供独立于血流因素的额外治疗益处。
