Yong Zhu1, Yingfan Mao2, Jun Chen3, Yudong Qiu4, Zhongqiu Wang1, Jian He2. 1. From the Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine. 2. Department of Radiology. 3. Department of Pathology. 4. Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China.
Abstract
OBJECTIVES: The aims of this study were to compare the difference of computed tomography (CT) features between intrahepatic cholangiocarcinomas (ICCs) with and without lymph node metastasis (LNM) and to construct a nomogram to predict LNM and overall survival preoperatively. METHODS: Clinicopathological and contrast-enhanced CT features of 63 patients with ICC were analyzed. Multivariate logistic regression analysis was performed to construct a nomogram to predict LNM preoperatively. Survival curves were drawn with the Kaplan-Meier method, and survival difference was compared. RESULTS: Intrahepatic cholangiocarcinomas with and without LNM differed significantly in clinical symptoms, tumor location, morphologic classification, arterial phase enhancement degree-mean, arterial phase enhancement degree-max, portal venous phase enhancement degree-max, equilibrium phase (EP) enhancement ratio, EP CT value-max, and EP CT value-max/liver. A nomogram based on morphologic classification, EP CT value-max, and EP enhancement ratio was constructed to predict LNM with an area under curve of 0.814 (P < 0.001). Patients with ICC with LNM risk of 0.20 or greater based on the nomogram showed a significantly poorer overall survival than those with LNM risk less than 0.20 (39.5 ± 5.2 vs 51.1 ± 4.7 months). CONCLUSIONS: Preoperative CT features of ICCs differed significantly between those with and without LNM. Nomogram based on those features could predict LNM and overall survival even better than the N stage.
OBJECTIVES: The aims of this study were to compare the difference of computed tomography (CT) features between intrahepatic cholangiocarcinomas (ICCs) with and without lymph node metastasis (LNM) and to construct a nomogram to predict LNM and overall survival preoperatively. METHODS: Clinicopathological and contrast-enhanced CT features of 63 patients with ICC were analyzed. Multivariate logistic regression analysis was performed to construct a nomogram to predict LNM preoperatively. Survival curves were drawn with the Kaplan-Meier method, and survival difference was compared. RESULTS:Intrahepatic cholangiocarcinomas with and without LNM differed significantly in clinical symptoms, tumor location, morphologic classification, arterial phase enhancement degree-mean, arterial phase enhancement degree-max, portal venous phase enhancement degree-max, equilibrium phase (EP) enhancement ratio, EP CT value-max, and EP CT value-max/liver. A nomogram based on morphologic classification, EP CT value-max, and EP enhancement ratio was constructed to predict LNM with an area under curve of 0.814 (P < 0.001). Patients with ICC with LNM risk of 0.20 or greater based on the nomogram showed a significantly poorer overall survival than those with LNM risk less than 0.20 (39.5 ± 5.2 vs 51.1 ± 4.7 months). CONCLUSIONS: Preoperative CT features of ICCs differed significantly between those with and without LNM. Nomogram based on those features could predict LNM and overall survival even better than the N stage.