Objective To explore the correlation between CT-based arterial enhancement fraction(AEF)and tumor shrinkage after neoadjuvant chemotherapy combined with immunotherapy for gastric cancer,so as to provide an imaging reference for predicting the therapeutic effect of combination chemotherapy and immunotherapy for gastric cancer patients.Methods 52 patients with gastric adenocarcinoma confirmed by biopsy and pathology and receiving neoadjuvant chemotherapy combined with immunotherapy were retrospectively collected.All patients underwent enhanced CT scanning before treatment.According to the postoperative pathological results,the patients were divided into good treatment(Becker scale:Grade 1-2:tumor residue＜50％)and poor efficacy(Grade 3:tumor residue＞50％).Some morphological features were recorded,tumor size and CT values of normal scan and enhanced phase were measured,and the artery enhancement fraction was calculated.The inter-group differences of CT parameters were compared,univariate and multivariate logistic regression were used to screen independent predictors of efficacy,receiver operating characteristic(ROC)curve was plotted,and area under the curve(AUC)was calculated to evaluate the predictive efficacy of the model.Results Smooth serous membrane was more common in patients with better efficacy(44.7％vs7.1％;the AEF of the lesion was higher than that of the poor treatment group(82.21(69.68,107.64)vs 59.31±5.70,P=0.003).Multivariate logistic regression(forward)results showed that there were smooth serous membrane features(OR=11.317,95％CI:1.169-109.545,P=0.036)and higher AEF(OR=1.045,95％CI:1.012-1.080,P=0.007)were independent predictors of better efficacy.ROC curve showed that AUC of multivariate logistic regression model was 0.853,95％CI:0.737-0.970,sensitivity:84.2％,specificity:85.7％.Conclusion AEF combined with serous membrane characteristics can predict the degree of tumor regression after neoadjuvant chemotherapy combined with immunotherapy for gastric cancer,which is helpful for the selection of preoperative treatment for patients.
维普
万方数据