基于CT三维重建与统计解剖学测量预测中晚期食管鳞状细胞癌患者化疗联合免疫治疗疗效

CHEN  Jincheng1; ZHANG  Xiaoqin2; LIU  Jie3; LI  Tongxin2; HE  Ping4; WU  Wei3*; WU Yi 2; 5*

doi:10.16098/j.issn.0529-1356.2026.01.004

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解剖学报 ›› 2026, Vol. 57 ›› Issue (1) : 22-29. DOI: 10.16098/j.issn.0529-1356.2026.01.004

机器人与手术导航专栏

基于CT三维重建与统计解剖学测量预测中晚期食管鳞状细胞癌患者化疗联合免疫治疗疗效

陈金城¹张小勤²刘杰³李童心²何萍⁴吴蔚^3*吴毅^2,5*

作者信息 +

Predicting efficacy of chemotherapy combined with immunotherapy in patients with mid to late stage esophageal squamous cell carcinoma based on CT three-dimensional reconstruction and statistical anatomical measurements

CHEN Jin-cheng¹, ZHANG Xiao-qin², LIU Jie³, LI Tong-xin², HE Ping⁴, WU Wei^3*, WU Yi ^2,5*

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文章历史 +

摘要

目的探讨影响中晚期食管鳞状细胞癌患者化疗联合免疫治疗反应的肿瘤形态学因素。方法回顾性收集了174例食管鳞状细胞癌患者治疗前CT和临床信息，根据实体瘤临床疗效评价标准（RECIST）1.1，将患者分为有反应组与无反应组。在CT图像上对食管肿瘤及其周围结构进行手动分割，三维重建并测量肿瘤及周围结构的形态学特征，最后分析不同反应组间的三维形态学特征差异。结果 174例患者中，有反应组103人（69.6%），无反应组45人（30.4%），两组治疗前临床特征未见统计学差异（P>0.05）。有反应组的肿瘤表面积、体积、长轴、肿瘤体积/正常食管体积、肿瘤长轴/正常食管长度均明显高于无反应组（5369.66 mm² vs 4262.40 mm²，26 781.21 mm³ vs 20 146.84 mm³，55.52 mm vs 47.19 mm，0.40 vs 0.33，0.23 vs 0.20，P<0.05）。有反应组的淋巴结体积和表面积明显高于无反应组，但差异无统计学意义（P>0.05）。通过接受者操作特性曲线（ROC）分析显示，肿瘤表面积、体积、长轴、肿瘤体积/正常食管体积、肿瘤长轴/正常食管长度的曲线下面积（AUC）值分别为0.636、0.630、0.617、0.606和0.629，其临界值分别为4074.50 mm²、20 215 mm³、49.21 mm、0.20和0.34。结论基于治疗前CT的肿瘤及其周围结构三维形态学特征，可以作为一种潜在的无创标志物，对中晚期食管鳞状细胞癌患者化疗联合免疫治疗反应进行有效预测，为临床决策提供帮助。

Abstract

Objective To investigate how these tumor characteristics influence the response to chemotherapy combined with immunotherapy in patients with mid to late stage esophageal squamous cell carcinoma. MethodsPre-treatment CT scans and clinical information from 174 patients diagnosed with esophageal squamous cell carcinoma were collected retrospectively. The patients were categorized into two groups: a responsive group and a non-responsive group, based on the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. The esophageal tumors and their surrounding structures were manually segmented on the CT images and then reconstructed in three dimensions. The morphological features of both the tumors and the neighboring structures were measured. Subsequently, the differences in three-dimensional morphological characteristics between the two response groups were analyzed. ResultsAmong the 174 patients, the responsive group comprised 103 individuals (69.6%), while the non-responsive group included 45 individuals (30.4%). There were no statistically significant differences in the pre-treatment clinical characteristics between the two groups (P>0.05). However, several measurements related to tumors were significantly higher in the responsive group compared to the non-responsive group, tumor surface area (5369.66 mm² vs 4262.40 mm²), volume (26 781.21 mm³ vs 20 146.84 mm³), long axis (55.52 mm vs 47.19 mm), tumor volume/normal esophageal volume (0.40 vs 0.33), and tumor long axis/normal esophageal length (0.23 vs 0.20) (P<0.05). Although the lymph node volume and surface area were also higher in the responsive group, the differences were not statistically significant (P>0.05). Additionally, the receiver operating characteristic curve (ROC) analysis indicated that the area under the curve (AUC) values for tumor surface area, volume, long axis, tumor volume/normal esophageal volume, and tumor long axis/normal esophageal length were 0.636, 0.630, 0.617, 0.606, and 0.629, respectively, with the corresponding cutoff values being 4074.50 mm², 20 215 mm³, 49.21 mm, 0.20, and 0.34. ConclusionThe three-dimensional morphological features of the tumor and its surrounding structures, as observed in pre-treatment CT scans, can serve as a potential non-invasive marker for predicting the effectiveness of chemotherapy combined with immunotherapy in patients with intermediate and advanced esophageal squamous carcinoma. This information could aid in clinical decision-making.

导出引用

陈金城张小勤刘杰李童心何萍吴蔚吴毅. 基于CT三维重建与统计解剖学测量预测中晚期食管鳞状细胞癌患者化疗联合免疫治疗疗效[J]. 解剖学报. 2026, 57(1): 22-29 https://doi.org/10.16098/j.issn.0529-1356.2026.01.004

CHEN Jin-cheng, ZHANG Xiao-qin, LIU Jie, LI Tong-xin, HE Ping, WU Wei, WU Yi.

[J]. Acta Anatomica Sinica. 2026, 57(1): 22-29 https://doi.org/10.16098/j.issn.0529-1356.2026.01.004

中图分类号： R323 R453.9

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