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case_images: The PD-L1 test results from the patient's tumor biopsy sample. The TPS is over 95%, and the CPS is over 90. (TPS, tumor proportion score, the ratio of PD-L1 stained tumor cells to total tumor cells x 100%; CPS, combined positive score; the ratio of PD-L1 stained cells to total tumor cells, including tumor cells, lymphocytes, and macrophages x 100. The negative expression of PD-L1 is TPS < 1%; the low expression is TPS > 1 and < 49%; and the high expression is TPS >= 50%).
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case_images: Given the positive PD-L1 test results from the patient's tumor biopsy sample ( Figure 1 ), we adjusted the patient's treatment strategy to TACE combine with a PD-1 monoclonal antibody therapy.
case_images: Comparison of CT images taken on December 18, 2020, and February 4, 2021. Compared to the CT image of 2020.12.18, the nodular masses of the pancreas's neck, the liver's hilar region, and the retroperitoneum were smaller. Multiple nodules were still present in the liver, and some exhibited slight changes following treatment, not significantly different from before.
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case_images: While multiple nodules were still present in the liver, some exhibited slight changes following treatment, although not significantly different from before ( Figure 2 ).
case_images: Typical PET-CT images at different time points before and after receiving treatment. The PET-CT of 2020.10.30 showed a mass with high FDG uptake, suggesting metastasis, liver metastasis, portal vein tumor thrombus, and metastasis to peripancreatic and retroperitoneal lymph nodes. After receiving treatment, intrahepatic lesions initially showed a significant decrease in size and FDG metabolism. In the 2022.01.27 and 2023.01.03 images, no increase in FDG metabolism was observed, and the primary peripancreatic and retroperitoneal metastatic lymph nodes and portal vein cancer thrombi have subsided.
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case_images: Figure 3 ). Furthermore, we supervised alterations in blood tumor markers, including
case_images: The variations in patient CA125 (A), CA199 (B), and CA50 (C) concentration levels before and after treatment administration. These tumor markers exhibited a transient elevation during the initial treatment phase and a subsequent decline below baseline levels.
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case_images: CA50, from the start of treatment ( Figure 4 ), which exhibited a transient elevation during the initial treatment phase and a subsequent decline below baseline levels. CA199, the most prevalent and well-studied pancreatic cancer marker, measures tumor burden but not metastatic potential. CA 50, a tumor marker for pancreatic cancer, is typically used with CA 199 to assess the prognosis. CA125 is a tumor marker for ovarian cancer and the most significant predictor of pancreatic cancer with metastases in recent years.