遵义医科大学学报2025，Vol.48Issue(7)：719-725,7.
特殊CT征象对胰腺导管腺癌的早期诊断价值
Noteworthy CT imaging finding in early stage of pancreatic ductal adenocarci-noma
黄志平 1路世龙 1李武铭 2李静 1林波淼1
作者信息
- 1. 南方医科大学珠江医院影像诊断科,广东 广州 510282
- 2. 广东省第二人民医院医学影像科,广东 广州 510317
- 折叠
摘要
Abstract
Objective To investigate the value of special signs on CT examination performed at least six months before the diagnosis of pancreatic ductal adenocarcinoma(PDAC)in suggesting ultra-early PDAC.Methods Pa-tients with pathological diagnosis of PDAC(36 cases)and control patients without pancreatic lesions(36 cases)were collected from June 2014 to January 2024,and CT signs were compared between the two groups.In addi-tion,patients with PDAC who showed indirect findings(IFs)on CT images were divided into the ILE(intra-pan-creatic late enhancement)alone group(ILE signs only)and the group with FPPA and/or MPDC,and clinical in-formation was collected for comparison between the two groups.Results IFs were present in 26 patients in the PDAC group,with a higher frequency of IFs compared to patients in the control group(10 patients)(72.2％vs 27.8％,P＜0.001);the most common IFs in patients in the PDAC group was ILE in 44.4％of the patients(16/36),whereas the most common IFs in patients in the control group was FPPA in 11.1％of the patients(4/36).Patients in the PDAC group presented with ILE(44.4％vs 8.3％,P=0.001)as well as FPPA(36.1％vs 11.1％,P=0.025)more frequently than controls.Multifactorial analysis showed that ILE(OR=1.875,P=0.003)and FPPA(OR=1.493,P=0.034)were independent predictors of PDAC.There was no significant difference in median TID between ILE alone and cases with FPPA and/or MPDC(P=0.073),and although there was no difference in surgical resection rates between the two groups(P＞0.05),patients in the ILE alone group had a significantly higher proportion of head lesions in the pancreas(70.0％vs 12.5％,P=0.009)and a higher frequency of jaundice(P=0.046)and CA 19-9(Z=2.054,P=0.040)levels were higher.Conclusion Focal pancreatic abnormality was detected in the majority of patients with PDAC on CT performed at least six months prior to the diagnosis,and ILE is an important CT indirect sign for the early detection of PDAC.关键词
胰腺/导管腺癌/间接征象/早期诊断Key words
pancreas/ductal adenocarcinoma/indirect findings/early diagnosis分类
医药卫生引用本文复制引用
黄志平,路世龙,李武铭,李静,林波淼..特殊CT征象对胰腺导管腺癌的早期诊断价值[J].遵义医科大学学报,2025,48(7):719-725,7.
