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

陈金城 张小勤 刘杰 李童心 何萍 吴蔚 吴毅

doi:10.16098/j.issn.0529-1356.2026.01.004

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Acta Anatomica Sinica ›› 2026, Vol. 57 ›› Issue (1) : 22-29. DOI: 10.16098/j.issn.0529-1356.2026.01.004

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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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.

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/ "> Esophageal squamous cell curcinoma / Immunotherapy / Computed tomography / Three-dimensional reconstruction / Retrospective analysis / Adult

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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

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