Assessment Of The Prognostic Value Of Intrahepatic Cholangiocarcinoma With Preoperative Contrast-Enhanced MSCT Scan

Objective:We practiced comparative analysis for the preoperative clinical,CT characteristics,and overall survival(OS)of patients with intrahepatic cholangiocarcinoma(ICC).And the prognostic nomogram of CT features was constructed to investigate the ability of the prediction model to predict the OS of ICC patients.Materials and Methods: 85 patients divided into two groups based on the equilibrium phase enhancement ratio.The enhancement of tumors more than two-thirds divided into Group 1(49 cases),and less than two-thirds of cancer divided into Group 2(36 cases).The clinicopathological characteristics,CT features,and enhancement patterns between the two groups were compared.Independent sample t-test or chi-square tests were used to compare the clinicopathological features and CT features of the two groups.These risk factors adopt a multivariate Cox regression analysis;prediction models were then constructed using these variables.Additionally,overall survival at different groups was analyzed using the Kaplan-Meier method,and differences were determined using a log-rank test.Results: There were statistically significant differences between the two groups in clinical symptoms(P=0.033),tumor size(p=0.005),tumor margins(P=0.021),necrosis or cystic change(P=0.033)and hepatic capsular invasion(p=0.014).The results of univariate analysis showed that CEA,CA125,tumor size,necrosis or cystic change,satellite lesions,tumor margin,peritumor enhancement,and the equilibrium phase enhancement ratio were risk factors for postoperative OS in ICC patients.Multivariate analysis showed that the equilibrium phase enhancement ratio(HR=2.341,95%CI: 1.095-5.055),tumor margins(HR=5.904,95%CI: 1.100-31.691)and satellite lesion(HR= 2.576,95%CI: 1.099-31.691)were independent risk factors for postoperative OS in ICC patients.In this study,the median overall survival time of ICC patients was 25 months,and the 1-year,2-year and 3-year overall survival were 64.2%,51.4% and 36.7%,respectively.To compare the overall survival of the two groups after the operation,the 1-year,2-year and 3-year overall survival of group 1 were 87.0%,73.3%,and 52.6%respectively;for group 2 patients,the median survival time was 11 months,The1-year,2-year,and 3-year overall survival were 73.3%,41.4%,and 18.6%,respectively.The difference in overall survival between the two groups was statistically significant(p = 0.003).Based on the preoperative CT characteristics,the nomogram model was established with a consistency index of 0.739(95%CI: 0.709-0.769).After calibration,the nomogram model predictions were in better agreement with the actual follow-up OS results.Conclusion: Preoperative MSCT multi-phase enhanced scanning has a certain predictive effect on the prognosis of ICC patients.The equilibrium phase enhancement ratio was less than two-thirds,the satellite lesions and the irregular tumor margins were independent risk factors for poor prognosis after ICC.The nomogram model can be used as a reliable predictive tool for preoperative imaging to predict postoperative OS of ICC patients.