在局部晚期胃癌患者中术后复发的预测因素,在新辅助疗法后达到病理完整反应:一项匹配的病例控制研究
Zhiqiang Jiang1, Jiankai Lyu1, Xiliang Cong1
1Department of General Surgery, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
Frontiers in oncology
|January 28, 2026
概括
在胃癌中达到病态完整反应 (pCR) 并不能保证治愈. 临床T阶段和新辅助化学免疫疗法是预测这些患者复发风险的关键因素.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 在新辅助疗法后的病理完整反应 (pCR) 是局部发达的胃/食道结癌的积极预后指标.
- 然而,一小部分实现pCR的患者仍然会出现复发.
- 确定预测该组复发的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 确定与局部晚期胃/胃食道结癌患者的复发相关的临床因素,这些患者在新辅助疗法后获得了pCR.
- 确定这种特定患者队列中复发的独立预测因子.
主要方法:
- 对16名患者进行了回顾性研究,在实现PCR后复发,根据年龄和性别与两个对照组相匹配 (每组不复发).
- 使用单变量和多变量逻辑回归分析对临床特征进行比较.
- 在单变量分析中P ≤ 0.1的因子被纳入多变量模型.
主要成果:
- 单变量分析显示,在复发和非复发组之间,瘤等级,新辅助疗法方案,PD-L1表达和手术前CEA水平存在显著差异.
- 多变量分析确定了临床T阶段和新辅助疗法作为复发的独立预后因素.
- 与cT3阶段和接受新辅助化疗免疫治疗的患者相比,与cT4阶段和化疗组相比,复发风险显著降低.
结论:
- 在新辅助疗法后实现pCR并不能消除胃/食道结癌复发的风险.
- 临床T阶段 (cT3 vs cT4) 和新辅助疗法 (化疗免疫疗法 vs 化疗) 是复发的独立预测因素.
- 在实现PCR的患者中识别高风险患者对于开发个性化监测和辅助治疗策略至关重要.
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