Association of tumor associated collagen signature with lymph node metastasis in pancreatic ductal adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive and fatal cancer with significant metastatic potential. Lymph node status is crucial for determining treatment options and predicting prognosis in pancreatic cancer patients. Current methods for estimating lymph node metastasis in PDAC are inadequate. This study developed and validated a novel nomogram that integrates macroscopic and microscopic tumor-associated collagen signatures (ma-TACS and mi-TACS) within the tumor microenvironment to assess the risk of lymph node metastasis in PDAC patients. This retrospective study included 150 PDAC patients, with 92 in the training cohort and 58 in the validation cohort. Ma-TACS and mi-TACS were obtained by multiphoton microscopy. Mi-TACS, which includes both morphological and textural features, were extracted from segmented regions of interest using Matlab 2022a. Ma-TACS and mi-TACS scores were calculated using ridge regression and LASSO regression analysis. Ma-TACS and mi-TACS scores are significantly related to lymph node metastasis in both univariate and multivariate logistic regression analyses (ma-TACS score, odds ratio, 2.304; 95% CI, 1.412-3.761;