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

Table 1 Distribution of pathological venous invasion outcomes (n = 167)

Grade	Definition	Cases
No invasion	Tumor cells are confined to the perivascular connective tissue surrounding the vein but do not penetrate the adventitial layer	39
Adventitial invasion	Tumor cells are confined to the adventitial layer of the vein and do not breach the external elastic lamina or invade deeper structures of the venous wall	47
Muscularis propria invasion	Tumor cells invade and are present within the smooth muscle layer of the venous wall (muscularis propria/muscular layer)	41
Intimal invasion	Tumor cells penetrate through the endothelial cell layer (endothelium) of the vein, becoming directly exposed to the vascular lumen, or are attached to/floating within the lumen (with or without thrombus formation)	40

Table 2 Univariate and multivariable analysis of venous invasion depth in patients with borderline resectable pancreatic cancer

Factors	Univariate analysis		Multivariate analysis
	χ2 value	P value	Odds ratio value	95% confidence interval	Wald	P value
Age (60 years old)	0.530	0.467
Gender	0.755	0.385
Smoking history	0.733	0.392
Diabetes history	1.090	0.296
Leukocyte count (× 109/L)	0.010	0.922
Neutrophil count (× 109/L)	0.658	0.417
Lymphocyte count (× 109/L)	0.029	0.865
Total bilirubin (μmol/L)	0.638	0.424
Gamma-glutamyl transferase (U/L)	0.112	0.738
Carcinoembryonic antigen (ng/mL)	0.554	0.457
CA19-9 (U/mL)	23.462	0.000	3.819	1.980-7.410	14.125	0.000
Regional lymph node enlargement (imaging)	3.469	0.063
Tumor size	2.086	0.149
Tumor location (head/body/tail/uncinate)	2.591	0.107
Venous invasion length	21.534	0.000	1.012	0.496-2.064	0.001	0.973
Circumferential involvement	83.009	0.000	8.271	3.950-17.320	33.352	0.000
Luminal compromise	75.556	0.000	3.544	1.818-6.447	8.489	0.004
Tumor-vein distance	17.961	0.000	0.434	0.180-1.044	3.469	0.063