Prognostic Correlation Analysis Of Radio ¹²⁵I Seed Interstitial Implantation For Pancreatic Cancer

Purpose:The purpose of this study was to explore the factors influencing the short-term efficacy of radioactive ¹²⁵I seed intertissue implantation for pancreatic cancer by analyzing tumor-related Wnt5a protein,CEUS performance and related quantitative parameters,as well as related serological indicators,in order to evaluate the risk of prognosis of radioactive ¹²⁵I seed intertissue implantation for pancreatic cancer.It may provide evaluation basis for more effective individualized diagnosis and treatment.Method:A total of 26 patients（26 lessons）with pancreatic cancer treated by ultrasound-guided ¹²⁵I seed implantation in our hospital from January 2020 to December 2021 were collected.There were 20 males and 6 females,ranging from 42 to 85 years old,with an average age of（61.46±11.95）years old.The maximum diameter of the lesion ranged from 1.2cm to 6.2cm.（1）26 lessons were examined by contrast-enhanced ultrasound and time-intensity curve（TIC）analysis.The size of 26 tumors were measured by imaging.Blood CA19-9 and blood glucose were detected in 26 cases.Ultrasound guided histological biopsy was performed on 11 lessons of 11 patients.Immunohistochemical staining was performed on the samples,and Wnt5a antibody was used to detect the expression of Wnt5a;（2）Surgical plan formulation;Surgical implementation;Immediate postoperative imaging verification confirmed that the particle implantation met the requirements of the TPS plan;（3）2 months after the operation,CT or MR was used to observe the changes of tumor size.CA19-9 and blood glucose were detected;（4）Patients were divided into two groups:the obvious effect group（reduced or not increased）and the non-obvious effect group（local or overall progression or metastasis around the lesion）.（5）The expression of Wnt5a protein between the two groups was compared and analyzed,and the differences of CEUS performance and quantitative parameters between the two groups were compared and analyzed,as well as the differences of relevant serological indicators between the two groups.Result:1.26 lessons were treated with ultrasound-guided particle implantation.2 months after the operation,the imaging follow-up was conducted:20 cases in the obvious effect group and 6 cases in the non-obvious effect group,with an effective rate of 76.9%.2.Immunohistochemical Wnt5a expression in 11 pancreatic cancer tissues was positive in cytoplasm,and negative in acinar cells and fibrous stroma in paracancer tissues.There was no statistical difference in the positive grade between the efficent group and the non-efficent group（P>0.05）.3.In the parameters of the CEUS time-intensity curve,the initial increase time of the prominent group was smaller than that of the non-prominent group,and the peak intensity of the prominent group was larger than that of the non-prominent group,with statistically significant differences（P<0.05）.There were no statistically significant differences in the peak time,rise slope and area under the curve（P>0.05）.4.There was no significant difference in preoperative CA19-9 between the two groups（P>0.05）,but there was significant difference in postoperative CA19-9（P<0.05）.The level of serum CA19-9 in the operative group was lower than that before operation,and the difference was statistically significant（P<0.05）,while there was no significant difference between the preoperative and postoperative levels of CA19-9 in the non-operative group（P>0.05）.The AUC value of POSTOPERATIVE CA19-9 ROC curve was 0.858,with a critical value of 341.10,a sensitivity of 66.7%,and a specificity of100%.There was statistically significant difference in postoperative blood glucose between the two groups（P<0.05）,and the postoperative blood glucose control level of patients in the prominent effect group was better than that in the non-prominent effect group,and the difference was statistically significant（P<0.05）.Conclusion:1.Ultrasound-guided interstitial implantation of radioactive ¹²⁵I seeds for the treatment of pancreatic cancer has significant short-term efficacy.Short initial hyperplasia time,high peak intensity,postoperative serum CA19-9<341.10U/m L and good postoperative blood glucose control（8.4mmol—11.2mmol/L）suggested good short-term efficacy.There was no significant correlation between the expression of Wnt5a protein and the prognosis of pancreatic cancer treated with radio125I seed intertissue implantation.2.Preoperative contrast-enhanced ultrasound examination is recommended for patients with pancreatic cancer,and time-intensity curve analysis is performed to estimate the postoperative short-term efficacy.Meanwhile,close follow-up of serum CA19-9 and effective control of blood glucose level are helpful to evaluate and promote prognosis.