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Purpose <p>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.</p> Methods <p>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.</p> Results <p>PASC tumors were significantly larger than PDAC tumors at baseline (<i>p</i> &lt; 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 <i>p</i> &lt; 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.</p> Conclusion <p>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.</p>

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Distinctive Endoscopic Ultrasound Features of Pancreatic Adenosquamous Carcinoma: A Propensity Score-Matched Analysis

  • 期刊论文

  • 发表日期：

    2026年7月2日

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  • Chen Ke,
  • Dang Yini,
  • Zheng Qiang,
  • He Ming,
  • Liu Jianqiang

摘要

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.