文章：

CT衍生的定量影像特征可高精度预测胃食管结合部腺癌新辅助治疗反应。

CT-Derived Quantitative Image Features Predict Neoadjuvant Treatment Response in Adenocarcinoma of the Gastroesophageal Junction with High Accuracy

原文发布日期：10 January 2025

DOI: 10.3390/cancers17020216

类型: Article

开放获取: 是

英文摘要：

Background: The purpose of this retrospective study was to evaluate the value of contrast-enhanced computed tomography (CE-CT) image features at baseline and after neoadjuvant chemotherapy in predicting histopathological response in patients with adenocarcinoma of the gastroesophageal junction (GEJ). Methods: A total of 105 patients with a diagnosis of adenocarcinoma of the GEJ were examined by CE-CT at baseline and preoperatively after neoadjuvant chemotherapy. All patients underwent surgical resection. Histopathological parameters and tumor regression grading according to Becker et al. were collected in 93 patients. Line profiles of the primary tumor area in baseline and preoperative CE-CT were generated using ImageJ. Maximum tumor density and tumor-to-wall density delta were calculated and correlated with the histopathological tumor response. In addition, tumor response was assessed according to standard RECIST measurements in all patients and by endoscopy in 72 patients. Results: Baseline and change in baseline to preoperative CE-CT parameters showed no significant differences between responders (Becker grade 1a, 1b) and non-responders (Becker grade 2, 3). After neoadjuvant therapy, responders and non-responders showed significant differences in maximum density and tumor-to-wall density delta values. Line profile measurements showed excellent inter-rater agreement. In comparison, neither RECIST nor endoscopy showed significant differences between these groups. Conclusions: Posttreatment CE-CT can predict histopathological therapy response to neoadjuvant treatment in adenocarcinoma of GEJ patients with high accuracy and thus may improve patient management.

摘要翻译： 

背景：本回顾性研究旨在评估基线期与新辅助化疗后增强计算机断层扫描（CE-CT）影像特征在预测胃食管结合部（GEJ）腺癌患者组织病理学反应中的价值。方法：共纳入105例确诊为GEJ腺癌的患者，分别在基线期和新辅助化疗后术前接受CE-CT检查。所有患者均接受手术切除。其中93例患者收集了组织病理学参数及根据Becker标准进行的肿瘤消退分级。使用ImageJ软件生成基线期和术前CE-CT中原发肿瘤区域的线性剖面图，计算最大肿瘤密度及肿瘤与胃壁密度差值，并与组织病理学肿瘤反应进行相关性分析。此外，所有患者均通过标准RECIST标准评估肿瘤反应，其中72例患者同时接受内镜检查评估。结果：基线期及基线至术前CE-CT参数的变化在应答者（Becker分级1a、1b级）与非应答者（Becker分级2、3级）间均无显著差异。新辅助治疗后，应答者与非应答者在最大密度及肿瘤与胃壁密度差值方面呈现显著差异。线性剖面测量显示出极佳的评估者间一致性。相比之下，RECIST标准与内镜检查均未显示两组间存在显著差异。结论：治疗后CE-CT能以高准确度预测GEJ腺癌患者对新辅助治疗的组织病理学反应，有望为临床治疗决策提供重要依据。

原文链接：

CT-Derived Quantitative Image Features Predict Neoadjuvant Treatment Response in Adenocarcinoma of the Gastroesophageal Junction with High Accuracy