胰腺腺鳞癌的增强CT表现与预后相关危险因素分析  

CT Imaging Features and Prognostic Risk Factors in Patients with Pancreatic Adenosquamous Carcinoma

作　　者：任帅 郭凯 张惠峰 赵瑞 刘希胜 王新波 王中秋 REN Shuai;GUO Kai;ZHANG Huifeng(Department of Radiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu Province 210029,P.R.China)

机构地区：[1]南京中医药大学附属医院(江苏省中医院)放射科,210029 [2]南京医科大学附属第一医院(江苏省人民医院)放射科,210029 [3]东部战区总医院普通外科,南京210002

出　　处：《临床放射学杂志》2021年第11期2153-2157,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:81771899);江苏省研究生科研与实践创新计划项目(编号:KYCX20-1477);国家留学基金委资助项目(编号:No.201909077001);江苏省重点研发计划(社会发展)项目(编号:BE2017772);江苏省中医药管理局面上项目(编号:ZD201907);江苏省中医院高峰学术人才项目(编号:y2018rc04)。

摘　　要：目的探讨胰腺腺鳞癌(PASC)的增强CT表现及预后相关危险因素。方法回顾性分析31例经病理证实的PASC患者的临床、病理及影像学资料,分析病灶的增强CT表现及其与预后的相关性。结果31例PASC患者平均发病年龄为(64.7±11.1)岁,男18例,女13例,病灶均为单发。PASC通常表现为边界不清(93.5%)、分叶状(71.0%)、以实性为主(80.6%)的肿块,增强后病灶周边常出现特征性“环征”(74.2%);病灶常可伴发血管侵犯(64.5%)、主胰管扩张(61.2%)、胰周侵犯(67.7%)及远处转移(35.5%)等征象。多因素Cox风险比例回归分析提示发生远处转移者出现较差预后为未发生远处转移者的7.5倍(P=0.004)。结论PASC通常表现为边界不清、分叶状、以实性为主的肿块,增强后病灶周边出现的特征性“环征”对于诊断PASC具有提示意义。常可伴发血管侵犯、主胰管扩张、胰周侵犯、远处转移等征象,其中,病灶发生远处转移往往提示患者预后较差。Objective To explore CT imaging features and prognostic risk factors in patients with pancreatic adenosquamous carcinoma(PASC).Methods The clinical,pathological,and imaging data of 31 pathologically proved PASC patients were retrospectively analyzed.CT imaging features and prognostic risk factors were analyzed.Results Thirty-one PASC patients(18 males and 13 females)with a mean age of 64.7±11.1 years old were included and 31 tumors were analyzed.PASC typically demonstrated ill-defined(93.5%),lobulated(71.0%),and predominantly solid masses(80.6%)with a characteristic contrast enhancement pattern of“ring sign".Imagingfindings including vascular invasion(64.5%),main pancreatic ductal dilatation(61.2%),peripancreatic invasion(67.7%),and metastases(35.5%),were common seen in PASC patients.Multivariate Cox proportional hazards model showed that the incidence of a poor prognosis in patients with metastases was 7.5-fold higher than that of patients without metastases.Conclusion PASC are often ill-defined,lobulated,predominantly solid masses with a characteristic contrast enhancement pattern of“ring sign”,which is indicative of PASC;Signs including vascular invasion,main pancreatic ductal dilatation,peripancreaticinvasion,and metastases are often associated with PASC.Metastases usually indicates a poor prognosis in PASC patients.

关 键 词：胰腺肿瘤 体层摄影术 X线计算机 生存分析 

分 类 号：R735.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]