CT Imaging Biomarkers Predict Clinical Outcomes After Pancreatic Cancer Surgery

• Published in: Medicine (Baltimore) Vol. 95; no. 5; p. e2664
• Main Authors: Zhu, Liang, Shi, Xiaohua, Xue, Huadan, Wu, Huanwen, Chen, Ge, Sun, Hao, He, Yonglan, Jin, Zhengyu, Liang, Zhiyong, Zhang, Zhuoli
• Format: Journal Article
• Language: English
• Published: United States The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved 01.02.2016; Wolters Kluwer Health
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - mortality; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Biomarkers; China - epidemiology; Contrast Media; Diagnostic Accuracy Study; Female; Humans; Image Processing, Computer-Assisted; Iohexol - analogs & derivatives; Male; Middle Aged; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - surgery; Retrospective Studies; Tomography, X-Ray Computed
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000002664

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.