Development and validation of a predictive model for portal-systemic venous invasion grading in borderline resectable pancreatic cancer

Figure 1 Hematoxylin and eosin staining. A-C: Microscopic appearance of no portal-systemic venous invasion; D-F: Microscopic appearance of portal-systemic venous invasion into the adventitia; G-I: Microscopic appearance of portal-systemic venous invasion into the muscularis propria; J-L: Microscopic appearance of portal-systemic venous invasion into the intimal. A, D, G, and J: 100 ×; B, E, H, and K: 200 ×; C, F, I, and L: 400 ×.

Figure 2 Prognosis of patients with borderline resectable pancreatic cancer undergoing radical resection. A: Overall postoperative survival curve (n = 167); B: Comparative postoperative survival curves by portal-systemic venous invasion grade: No invasion group (n = 39), adventitial invasion group (n = 47), muscularis propria invasion group (n = 41), and intimal invasion group (n = 40).

Figure 3 Nomogram for predicting pathological portal-systemic venous invasion grade in borderline resectable pancreatic cancer. This nomogram incorporates 3 independent predictors identified by multivariable analysis: Preoperative serum carbohydrate antigen 19-9 (U/mL), circumferential involvement (°), and luminal compromise (%). CA19-9: Carbohydrate antigen 19-9.

Figure 4 Calibration curve analysis for portal-systemic venous invasion depth prediction model. A: No invasion (No_Invasion); B: Adventitial invasion (Adventitial_Invasion); C: Muscularis propria invasion (Muscularis_Propria_Invasion); D: Intimal invasion (Intimal_Invasion).

Figure 5 Decision curve analysis curves. A: No invasion (No_Invasion); B: Adventitial invasion (Adventitial_Invasion); C: Muscularis propria invasion (Muscularis_Propria_Invasion); D: Intimal invasion (Intimal_Invasion). DCA: Decision curve analysis.