肿瘤预防与治疗2026，Vol.39Issue(3)：190-197,8.DOI:10.3969/j.issn.1674-0904.2026.03.003
基于CT定量参数和肿瘤标志物的局部进展期胃癌新辅助免疫化疗病理反应的列线图预测模型研究
Development of a Nomogram Prediction Model for Pathological Response to Neoadjuvant Immunochemotherapy in Locally Advanced Gastric Canc-er Based on Quantitative CT Radiomics and Tumor Markers
摘要
Abstract
Objective:To explore the value of a nomogram incorporating CT radiomics and tumor markers in predicting pathological response to immunochemotherapy in locally advanced gastric cancer.Methods:A total of 276 patients with lo-cally advanced gastric cancer treated at our hospital between January 2022 and June 2025 were enrolled.All patients under-went neoadjuvant immunochemotherapy followed by pathological response assessment.Clinical baseline data,CT imaging pa-rameters,and tumor marker levels were compared between patients who achieved a pathological response and those who did not.Multivariable analysis was performed to identify factors influencing pathological response to neoadjuvant immunochemo-therapy in locally advanced gastric cancer.These factors were then incorporated into a nomogram for individualized prediction of pathological response.Results:Among 276 patients undergoing neoadjuvant immunochemotherapy for locally advanced gastric cancer,50.36%achieved a pathological response,while 49.64%did not.Among pathological responders,the pro-portions of patients with Borrmann type I～II,T2 stage,and N0 stage were 47.48%,23.02%,and 21.58%,respectively,which were significantly higher than those among non-responders(all P<0.05).In pathological responders,the standard-ized thickness of the tumor area,standardized CT value of the tumor area,and levels of carbohydrate antigen 125,carcino-embryonic antigen(CEA),and carbohydrate antigen 199 were 4.45(2.93,6.10),0.65(0.38,0.92),42.50(23.34,68.12)U/L,32.40(14.20,58.40)ng/mL,and 62.34(28.34,98.45)U/L,respectively.These values were signifi-cantly lower than those in pathological non-responders(P<0.05).Logistic regression analysis showed that Borrmann classi-fication,T stage,standardized thickness of the tumor area,and CEA level were independent factors significantly associated with pathological response(P<0.01).The nomogram achieved an AUC of 0.890(95%CI:0.853～0.928,P<0.05)for predicting pathological response,with a sensitivity of 85.6%and a specificity of 79.6%.Decision curve analysis demonstrated that the nomogram provided a positive net benefit across a threshold probability range of 0.1～0.94,indicating good clinical usefulness.Conclusion:The nomogram incorporating CT quantitative parameters and tumor markers serves as a valuable tool for predicting pathological response to neoadjuvant immunochemotherapy in patients with locally advanced gastric cancer.关键词
CT/肿瘤标志物/列线图模型/局部进展期胃癌/新辅助免疫化疗/病理反应Key words
CT/Tumor markers/Nomogram/Locally advanced gastric cancer/Immunochemotherapy/Pathological reaction分类
医药卫生引用本文复制引用
郭宇,霍俊杰,杨晨涛,刘锋波,刘莎,李晓军,魏立杰,杨笑一..基于CT定量参数和肿瘤标志物的局部进展期胃癌新辅助免疫化疗病理反应的列线图预测模型研究[J].肿瘤预防与治疗,2026,39(3):190-197,8.基金项目
邢台市重点研发计划(编号:2023ZC127) This study was supported by grants from Xingtai Sci-ence and Technology Bureau(No.2023ZC127). （编号:2023ZC127）
