{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:19:23Z","timestamp":1790968763021,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971463"],"award-info":[{"award-number":["81971463"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82003073"],"award-info":[{"award-number":["82003073"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007162","name":"Guangdong Provincial Department of Science and Technology","doi-asserted-by":"publisher","award":["2020A1515011296"],"award-info":[{"award-number":["2020A1515011296"]}],"id":[{"id":"10.13039\/501100007162","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate the extracellular matrix of pancreatic ductal adenocarcinoma (PDAC) using the extracellular volume fraction (fECV) derived from enhanced CT images, integrating fECV with \u03b1\u2010SMA\u2010positive cancer\u2010associated fibroblasts (CAFs) and FAP\u2010positive CAFs to investigate their relationship with clinicopathological characteristics and prognosis of patients with PDAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of 124 patients who underwent surgical resection for PDAC was conducted. Immunohistochemistry was applied to determine the expression of \u03b1\u2010SMA and FAP. fECV was calculated by attenuation values of PDAC and aorta. The Kaplan\u2013Meier method was used to plot the postoperative overall survival (OS) and disease\u2010free survival (DFS) curves. A Cox proportional hazards regression model was used to develop a predictive model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      High \u03b1\u2010SMA (OS:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; DFS:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.065) and FAP (OS:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; DFS:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) expressions and low fECV (OS:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; DFS:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) predict poor prognosis. Patients with co\u2010high expression of \u03b1\u2010SMA and FAP had worse OS and DFS. Multivariable analysis identified \u03b1\u2010SMA (OS: hazard ratio [HR], 2.34 [95% CI, 1.30\u20134.21],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), FAP (OS: HR, 4.43 [95% CI, 2.72\u20137.19],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and fECV (OS: HR, 0.58 [95% CI, 0.37\u20130.90],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) as independent predictors of prognosis. The predictive model established by combining fECV with \u03b1\u2010SMA and FAP in this study cohort demonstrated the best predictive value.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The integration of fECV with \u03b1\u2010SMA and FAP expressions offers a robust method for predicting clinical outcomes in PDAC patients, potentially guiding treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71281","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T09:46:32Z","timestamp":1759398392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Extracellular Volume Fraction Combined With Pathological Features of \u03b1\u2010SMA and FAP for Predicting the Prognosis of Patients With Pancreatic Ductal Adenocarcinoma After Surgery and Evaluating the Efficacy of Chemotherapy"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9997-8182","authenticated-orcid":false,"given":"Liqiang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Biliary and Pancreatic Surgery, Sun Yat\u2010Sen Memorial Hospital Sun Yat\u2010Sen University  Guangzhou P.R. 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