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Abstract：
UNASSIGNED: The aim of this study was to evaluate the prognostic value of imaging-based variables and tumor marker in predicting the progression-free survival (PFS) in treatment-naïve pancreatic cancer (PC) using baseline 18-fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT).
UNASSIGNED: This retro-prospective study was conducted at PET/CT imaging facility of JCIA health-care facility of Pakistan. Total 68 patients with PCs were retrospectively included who had 18FDG PET/CT for staging from March 2017 to December 2020. Thirty-two patients had unresectable Stage IV disease on baseline imaging while the remaining 36 underwent Whipple\'s procedure and both categories were followed by chemotherapy with/without immunotherapy. These patients were followed for a median period of 18 months (1-62 months) for PFS. Logistic regression analysis and receiver operating characteristic (ROC) analysis were used for independent predictors of patients\' demographics, tumor characteristics, CA 19-9, and maximum standardized uptake value (SUVmax) in PFS. Kaplan-Meier\'s survival curves were analyzed to measure PFS using ROC-derived significant cutoff values of CA 19-9 and SUVmax.
UNASSIGNED: Median PFS was 18 months (11-45) with 60% (41/68) patients were either died or labelled having metabolic progressive disease (MPD. Using logistic regression analysis, significant correlations were found for Stage IV disease and pancreatic body/tail tumor with disease progression (odd ratio: 7.535 and 4.803, respectively; P < 0.05). Gender, obesity, histological tumor type, and 18FDG-avid regional nodes did not show a significant impact on PFS. On ROC analysis, SUVmax >5.3 of primary tumor and baseline CA 19-9 >197 U/ml were found to have a significant negative correlation with PFS (area under the curve: 0.827 and 0.911, respectively; P < 0.0001) and no association of age and primary tumor size in PFS. Significantly, shorter PFS was found using ROC-derived cutoff values of SUVmax >5.3 versus ≤5.3 of primary tumor (mean and 95% confidence interval [CI]: 16.7 vs. 48.5 and 10-23 vs. 41-56; log-rank = 25.014; P < 0.0001) and baseline CA 19-9 >197 versus ≤197 U/ml (mean and 95% CI: 11.8 vs. 46.9 and 7-16 vs. 39-55; log-rank = 38.217; P < 0.0001).
UNASSIGNED: SUVmax >5.3 of primary tumor and baseline CA 19-9 >197 U/ml were found to have a significant negative correlation with PFS in treatment-naïve PC patients. Among demographics, only Stage IV disease and pancreatic tail and body tumors were found to have a negative association with disease progression.
UNASSIGNED: This retro-prospective study was conducted at PET/CT imaging facility of JCIA health-care facility of Pakistan. Total 68 patients with PCs were retrospectively included who had 18FDG PET/CT for staging from March 2017 to December 2020. Thirty-two patients had unresectable Stage IV disease on baseline imaging while the remaining 36 underwent Whipple\'s procedure and both categories were followed by chemotherapy with/without immunotherapy. These patients were followed for a median period of 18 months (1-62 months) for PFS. Logistic regression analysis and receiver operating characteristic (ROC) analysis were used for independent predictors of patients\' demographics, tumor characteristics, CA 19-9, and maximum standardized uptake value (SUVmax) in PFS. Kaplan-Meier\'s survival curves were analyzed to measure PFS using ROC-derived significant cutoff values of CA 19-9 and SUVmax.
UNASSIGNED: Median PFS was 18 months (11-45) with 60% (41/68) patients were either died or labelled having metabolic progressive disease (MPD. Using logistic regression analysis, significant correlations were found for Stage IV disease and pancreatic body/tail tumor with disease progression (odd ratio: 7.535 and 4.803, respectively; P < 0.05). Gender, obesity, histological tumor type, and 18FDG-avid regional nodes did not show a significant impact on PFS. On ROC analysis, SUVmax >5.3 of primary tumor and baseline CA 19-9 >197 U/ml were found to have a significant negative correlation with PFS (area under the curve: 0.827 and 0.911, respectively; P < 0.0001) and no association of age and primary tumor size in PFS. Significantly, shorter PFS was found using ROC-derived cutoff values of SUVmax >5.3 versus ≤5.3 of primary tumor (mean and 95% confidence interval [CI]: 16.7 vs. 48.5 and 10-23 vs. 41-56; log-rank = 25.014; P < 0.0001) and baseline CA 19-9 >197 versus ≤197 U/ml (mean and 95% CI: 11.8 vs. 46.9 and 7-16 vs. 39-55; log-rank = 38.217; P < 0.0001).
UNASSIGNED: SUVmax >5.3 of primary tumor and baseline CA 19-9 >197 U/ml were found to have a significant negative correlation with PFS in treatment-naïve PC patients. Among demographics, only Stage IV disease and pancreatic tail and body tumors were found to have a negative association with disease progression.
摘要：
■这项研究的目的是使用基线18-氟脱氧葡萄糖（18FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）评估基于成像的变量和肿瘤标志物在预测未治疗胰腺癌（PC）的无进展生存期（PFS）中的预后价值。
■这项前瞻性研究是在巴基斯坦JCIA医疗机构的PET/CT成像机构进行的。从2017年3月至2020年12月，共有68例PC患者进行了18FDGPET/CT分期。32例患者在基线成像中患有不可切除的IV期疾病，而其余36例接受了Whipple的手术，并且这两个类别都接受了有/无免疫治疗的化疗。这些患者的PFS中位随访时间为18个月（1-62个月）。Logistic回归分析和受试者工作特征（ROC）分析用于患者的独立预测因素，肿瘤特征，CA19-9和PFS中的最大标准化摄取值(SUVmax)。使用ROC衍生的CA19-9和SUVmax的显著截止值分析Kaplan-Meier存活曲线以测量PFS。
■PFS中位数为18个月（11-45），其中60％（41/68）的患者死亡或被标记为代谢进行性疾病（MPD。使用逻辑回归分析，发现IV期疾病和胰腺体/尾肿瘤与疾病进展显着相关（奇数比：分别为7.535和4.803；P<0.05）。性别,肥胖，组织学肿瘤类型，和18FDG-avid区域节点对PFS没有显着影响。在ROC分析中，原发性肿瘤的SUVmax>5.3，基线CA19-9>197U/ml与PFS呈显著负相关（曲线下面积分别为0.827和0.911；P<0.0001），年龄和原发性肿瘤大小与PFS无相关性。重要的是,使用ROC衍生的SUVmax>5.3与≤5.3原发肿瘤的截断值发现较短的PFS（平均值和95％置信区间[CI]：16.7vs.48.5和10-23vs.41-56；log-rank=25.014；P<0.0001）和基线CA19-9>197vs.≤197U/ml（平均值和95％CI：11.8vs.46.9和7-16vs.39-55；对数秩=38.217；P<0.0001）。
■SUVmax>5.3原发肿瘤和基线CA19-9>197U/ml与未治疗PC患者的PFS呈显著负相关。在人口统计中，仅发现IV期疾病和胰尾及体肿瘤与疾病进展呈负相关.
■这项前瞻性研究是在巴基斯坦JCIA医疗机构的PET/CT成像机构进行的。从2017年3月至2020年12月，共有68例PC患者进行了18FDGPET/CT分期。32例患者在基线成像中患有不可切除的IV期疾病，而其余36例接受了Whipple的手术，并且这两个类别都接受了有/无免疫治疗的化疗。这些患者的PFS中位随访时间为18个月（1-62个月）。Logistic回归分析和受试者工作特征（ROC）分析用于患者的独立预测因素，肿瘤特征，CA19-9和PFS中的最大标准化摄取值(SUVmax)。使用ROC衍生的CA19-9和SUVmax的显著截止值分析Kaplan-Meier存活曲线以测量PFS。
■PFS中位数为18个月（11-45），其中60％（41/68）的患者死亡或被标记为代谢进行性疾病（MPD。使用逻辑回归分析，发现IV期疾病和胰腺体/尾肿瘤与疾病进展显着相关（奇数比：分别为7.535和4.803；P<0.05）。性别,肥胖，组织学肿瘤类型，和18FDG-avid区域节点对PFS没有显着影响。在ROC分析中，原发性肿瘤的SUVmax>5.3，基线CA19-9>197U/ml与PFS呈显著负相关（曲线下面积分别为0.827和0.911；P<0.0001），年龄和原发性肿瘤大小与PFS无相关性。重要的是,使用ROC衍生的SUVmax>5.3与≤5.3原发肿瘤的截断值发现较短的PFS（平均值和95％置信区间[CI]：16.7vs.48.5和10-23vs.41-56；log-rank=25.014；P<0.0001）和基线CA19-9>197vs.≤197U/ml（平均值和95％CI：11.8vs.46.9和7-16vs.39-55；对数秩=38.217；P<0.0001）。
■SUVmax>5.3原发肿瘤和基线CA19-9>197U/ml与未治疗PC患者的PFS呈显著负相关。在人口统计中，仅发现IV期疾病和胰尾及体肿瘤与疾病进展呈负相关.
