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. 2016 Feb;95(5):e2664.
doi: 10.1097/MD.0000000000002664.

CT Imaging Biomarkers Predict Clinical Outcomes After Pancreatic Cancer Surgery

Liang Zhu  1 , Xiaohua Shi, Huadan Xue, Huanwen Wu, Ge Chen, Hao Sun, Yonglan He, Zhengyu Jin, Zhiyong Liang, Zhuoli Zhang
Affiliations

CT Imaging Biomarkers Predict Clinical Outcomes After Pancreatic Cancer Surgery

Liang Zhu et al. Medicine (Baltimore). 2016 Feb.

Erratum in

Abstract

This study aimed to determine whether changes in contrast-enhanced computed tomography (CT) parameters could predict postsurgery overall and progression-free survival (PFS) in pancreatic cancer patients. Seventy-nine patients with a final pathological diagnosis of pancreatic adenocarcinoma were included in this study from June 2008 to August 2012. Dynamic contrast-enhanced (DCE) CT of tumors was obtained before curative-intent surgery. Absolute enhancement change (AEC) and relative enhancement change (REC) were evaluated on DCE-CT. PFS and overall survival (OS) were compared based on CT enhancement patterns. The markers of fibrogenic alpha-smooth muscle antigen (α-SMA) and periostin in tumor specimens were evaluated by immunohistochemical staining. The χ test was performed to determine whether CT enhancement patterns were associated with α-SMA-periostin expression levels (recorded as positive or negative). Lower REC (<0.9) was associated with shorter PFS (HR 0.51, 95% CI: 0.31-0.89) and OS (HR 0.44, 95% CI: 0.25-0.78). The α-SMA and periostin expression level were negatively correlated with REC (both P = 0). Among several CT enhancement parameters, REC was the best predictor of patient postsurgery survival. Low REC was associated with a short progression-free time and poor survival. The pathological studies suggested that REC might be a reflection of cancer fibrogenic potential.

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Conflict of interest statement

The authors received fundings from Natural Science Foundation of China (No.201402001, No.81371608). The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
A 53-year-old woman with an isoattenuating mass in the pancreatic body. Pathology confirmed pancreatic ductal adenocarcinoma. A circular ROI was placed within the tumor on noncontrast images (A). The ROI was copied and pasted to the same position on PP (B) and PV (C) phase images, which were manually coregistered. ROIs of similar sizes were placed within normal parenchyma on noncontrast (D), PP (E), and PV (F) phase images.
FIGURE 2
FIGURE 2
A 47-year-old man with pancreatic adenocarcinoma confined in the pancreatic uncinate. A ROI was placed within the tumor on carefully coregistered noncontrast images (A) and PP (B) and PV (C) phase images; another circular ROI of similar size was placed within the normal parenchyma on noncontrast (D), PP (E), and PV (F) phase images.
FIGURE 3
FIGURE 3
Representative examples of positive and negative staining of α-SMA (A and B, respectively) and periostin (C and D, respectively) in a resected pancreatic cancer tissue specimen.
FIGURE 4
FIGURE 4
Progression-free survival for low-REC patients and high-REC patients.
FIGURE 5
FIGURE 5
Overall survival for low-REC patients and high-REC patients.
See this image and copyright information in PMC

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