Digestive diseases and sciences · 2026
Distinctive Endoscopic Ultrasound Features of Pancreatic Adenosquamous Carcinoma: A Propensity Score-Matched Analysis.
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Ke Chen, Yini Dang, Qiang Zheng, Ming He, Jianqiang Liu
Аннотация
PURPOSE: Pancreatic adenosquamous carcinoma (PASC) is a rare and aggressive malignancy with poorer prognosis than pancreatic ductal adenocarcinoma (PDAC). This study aimed to identify distinctive endoscopic ultrasound (EUS) features for pre-operative differentiation between PASC and PDAC.
METHODS: Forty-six PASC patients and 683 PDAC patients were retrospectively enrolled. Propensity score matching (1:2) balanced age, sex, and tumor size. EUS characteristics were compared, and independent predictors were identified by multivariate logistic regression.
RESULTS: PASC tumors were significantly larger than PDAC tumors at baseline (p < 0.001). After matching, multivariate analysis identified five independent predictors of PASC: higher serum albumin (OR = 1.256), hyperechoic foci (OR = 7.733), non-infiltrative growth pattern (INF C: OR = 0.163), and absence of pancreatic duct dilation (positive: OR = 0.021; unknown: 0.008) (all p < 0.05). The model demonstrated good discrimination with an AUC of 0.931 (95% CI 0.888-0.974). PASC more frequently exhibited hyperechoic foci (69.6% vs. 34.8%) and expansive growth, while PDAC typically showed infiltrative growth and duct dilation.
CONCLUSION: PASC demonstrates distinctive EUS features including hyperechoic foci, expansive growth pattern, and less frequent ductal obstruction compared with PDAC, which may facilitate pre-operative differentiation from PDAC.
METHODS: Forty-six PASC patients and 683 PDAC patients were retrospectively enrolled. Propensity score matching (1:2) balanced age, sex, and tumor size. EUS characteristics were compared, and independent predictors were identified by multivariate logistic regression.
RESULTS: PASC tumors were significantly larger than PDAC tumors at baseline (p < 0.001). After matching, multivariate analysis identified five independent predictors of PASC: higher serum albumin (OR = 1.256), hyperechoic foci (OR = 7.733), non-infiltrative growth pattern (INF C: OR = 0.163), and absence of pancreatic duct dilation (positive: OR = 0.021; unknown: 0.008) (all p < 0.05). The model demonstrated good discrimination with an AUC of 0.931 (95% CI 0.888-0.974). PASC more frequently exhibited hyperechoic foci (69.6% vs. 34.8%) and expansive growth, while PDAC typically showed infiltrative growth and duct dilation.
CONCLUSION: PASC demonstrates distinctive EUS features including hyperechoic foci, expansive growth pattern, and less frequent ductal obstruction compared with PDAC, which may facilitate pre-operative differentiation from PDAC.