Abstract：
OBJECTIVE: To investigate the clinical significance and stage migration effect of radiological diameter-to-thickness (DT) ratio in HER2-positive resectable advanced gastric cancer (HER2-p RAGC).
METHODS: 369 HER2-p RAGC patients were retrospectively enrolled and information on clinical pathological characteristics, radiological DT ratio, and outcomes [i.e., overall survival (OS) and progression-free survival (PFS)] was collected. Pearson\'s Chi-square and Student\'s t-test were employed to compare baseline characteristics. Clinical outcomes were estimated using Kaplan-Meier analysis and Log-rank test. Univariate and multivariate Cox regression models were utilized to analyze independent prognostic factors.
RESULTS: HER2-p RAGC patients were stratified into two groups using a DT ratio cutoff value of 4.0 (p < 0.05). Patients with a DT ratio < 4.0 exhibited significantly longer OS (58.0 vs. 31.0 months) and PFS (43.0 vs. 24.0 months) than those with a DT ratio ≥ 4.0. DT ratio significantly predicted prognosis for N0 and II stage patients (p < 0.05). Patients with gastric body and antrum cancers demonstrated longer OS and PFS in the DT ratio < 4.0 group (p = 0.046, 0.017, 0.036 and 0.028). Multivariate Cox proportional hazard model identified age, pathological T category, pathological N category, pathological TNM category and DT ratio as independent prognostic factors. Notably, pStage II patients with a DT ratio ≥ 4.0 exhibited a similar prognosis to pStage III patients with a DT ratio < 4.0 (p = 0.418 for OS, 0.867 for PFS).
CONCLUSIONS: Radiological DT ratio could evaluate the prognosis and detect higher malignant cases in HER2-p RAGC patients. Moreover, DT ratio might guide clinicians make postoperative strategies.
BACKGROUND: Retrospectively registered.
METHODS: 369 HER2-p RAGC patients were retrospectively enrolled and information on clinical pathological characteristics, radiological DT ratio, and outcomes [i.e., overall survival (OS) and progression-free survival (PFS)] was collected. Pearson\'s Chi-square and Student\'s t-test were employed to compare baseline characteristics. Clinical outcomes were estimated using Kaplan-Meier analysis and Log-rank test. Univariate and multivariate Cox regression models were utilized to analyze independent prognostic factors.
RESULTS: HER2-p RAGC patients were stratified into two groups using a DT ratio cutoff value of 4.0 (p < 0.05). Patients with a DT ratio < 4.0 exhibited significantly longer OS (58.0 vs. 31.0 months) and PFS (43.0 vs. 24.0 months) than those with a DT ratio ≥ 4.0. DT ratio significantly predicted prognosis for N0 and II stage patients (p < 0.05). Patients with gastric body and antrum cancers demonstrated longer OS and PFS in the DT ratio < 4.0 group (p = 0.046, 0.017, 0.036 and 0.028). Multivariate Cox proportional hazard model identified age, pathological T category, pathological N category, pathological TNM category and DT ratio as independent prognostic factors. Notably, pStage II patients with a DT ratio ≥ 4.0 exhibited a similar prognosis to pStage III patients with a DT ratio < 4.0 (p = 0.418 for OS, 0.867 for PFS).
CONCLUSIONS: Radiological DT ratio could evaluate the prognosis and detect higher malignant cases in HER2-p RAGC patients. Moreover, DT ratio might guide clinicians make postoperative strategies.
BACKGROUND: Retrospectively registered.
摘要：
目的：探讨HER2阳性可切除进展期胃癌(HER2-pRAGC)放射径厚比(DT)的临床意义及分期迁移效应。
方法：369例HER2-pRAGC患者的临床病理特征，放射学DT比，和结果[即，收集总生存期(OS)和无进展生存期(PFS)].采用Pearson卡方和Studentt检验比较基线特征。使用Kaplan-Meier分析和Log-rank检验估计临床结果。采用单因素和多因素Cox回归模型分析影响预后的独立因素。
结果：HER2-pRAGC患者使用4.0的DT比值截断值分为两组（p<0.05）。DT比率<4.0的患者表现出明显更长的OS（58.0vs.31.0个月）和PFS（43.0与24.0个月）比DT比率≥4.0的那些。DT比值可显著预测N0期和II期患者的预后(p<0.05)。在DT比率<4.0组中，患有胃体癌和胃窦癌的患者表现出更长的OS和PFS（p=0.046、0.017、0.036和0.028）。多变量Cox比例风险模型识别年龄，病理T类,病理N类，病理TNM类别和DT比率是独立的预后因素。值得注意的是,DT比率≥4.0的pII期患者表现出与DT比率<4.0的pIII期患者相似的预后（对于OS，p=0.418，0.867用于PFS)。
结论：放射学DT比可以评估HER2-pRAGC患者的预后并检测到较高的恶性病例。此外，DT比值可指导临床医生制定术后策略。
背景：回顾性注册。
方法：369例HER2-pRAGC患者的临床病理特征，放射学DT比，和结果[即，收集总生存期(OS)和无进展生存期(PFS)].采用Pearson卡方和Studentt检验比较基线特征。使用Kaplan-Meier分析和Log-rank检验估计临床结果。采用单因素和多因素Cox回归模型分析影响预后的独立因素。
结果：HER2-pRAGC患者使用4.0的DT比值截断值分为两组（p<0.05）。DT比率<4.0的患者表现出明显更长的OS（58.0vs.31.0个月）和PFS（43.0与24.0个月）比DT比率≥4.0的那些。DT比值可显著预测N0期和II期患者的预后(p<0.05)。在DT比率<4.0组中，患有胃体癌和胃窦癌的患者表现出更长的OS和PFS（p=0.046、0.017、0.036和0.028）。多变量Cox比例风险模型识别年龄，病理T类,病理N类，病理TNM类别和DT比率是独立的预后因素。值得注意的是,DT比率≥4.0的pII期患者表现出与DT比率<4.0的pIII期患者相似的预后（对于OS，p=0.418，0.867用于PFS)。
结论：放射学DT比可以评估HER2-pRAGC患者的预后并检测到较高的恶性病例。此外，DT比值可指导临床医生制定术后策略。
背景：回顾性注册。
