Published online Jun 14, 2022. doi: 10.3748/wjg.v28.i22.2468
Peer-review started: August 3, 2021
First decision: October 2, 2021
Revised: October 31, 2021
Accepted: May 16, 2022
Article in press: May 16, 2022
Published online: June 14, 2022
Processing time: 310 Days and 10 Hours
Computed tomography (CT) is widely used in the diagnosis, staging and treatment of pancreatic tumours. Because being rich in stroma, pancreatic cancer generally shows a low enhancement pattern compared with normal pancreatic tissue.
We want to use preoperative enhanced CT as a quantitative imaging biomarker to accurately predict the prognosis of patients with pancreatic cancer.
To analyse prognostic value of preoperative enhanced CT in pancreatic cancer.
Sixty-seven patients with pancreatic ductal adenocarcinoma undergoing pancreatic resection were enrolled retrospectively. All patients underwent preoperative unenhanced and enhanced CT examination, the CT values of which were measured. The ratio of the preoperative CT value increase from the nonenhancement phase to the portal venous phase between pancreatic tumour and normal pancreatic tissue was calculated. The cut-off value of ratios was obtained by the receiver operating characteristic curve of the tumour relative enhancement ratio (TRER), according to which patients were divided into low- and high-enhancement groups. Cox regression was performed for the univariate (enter model) and multivariate analyses (forward LR model). Finally, Spearman rank correlation or chi-square test was used to analyse the correlation between TRER and clinicopathological characteristics.
TRER is a quantitative index of enhancement CT. This study showed that the prognosis of patients with the TRER ≤ 0.7 was significantly worse. TRER is a simple and effective parameter. Our results demonstrated that patients in the low TRER group were more likely to have higher American Joint Committee on Cancer stage, tumour stage, lymph node stage, and TRER was significantly negatively correlated with tumour size.
TRER is a quantitative indicator of enhanced CT and can be used to predict postoperative overall survival in pancreatic cancer.
In the future, we will further study the value of preoperative enhanced CT in predicting the efficacy of chemotherapy.