新辅助化疗已成为局部晚期胃癌的标准治疗方案。肿瘤退化级别系统是评估新辅助化疗治疗反应的一种有效且广泛使用的工具。然而，临床特征是否可以预测肿瘤退化级别仍不确定。本研究回顾性纳入了2014年至2021年的共287例局部晚期胃癌患者。根据美国病理学家学会的肿瘤退化级别系统，将患者分为反应组（肿瘤退化级别0-1）和非反应组（肿瘤退化级别2-3）。采用 logistic 回归模型分析临床特征与新辅助化疗反应之间的关联性。采用 Kaplan-Meier 方法估计生存率。根据多变量分析的β系数构建预测评分系统。采用受试者工作特征曲线和决策曲线分析评估预测评分系统的性能。生存分析显示，肿瘤退化级别为0至1的患者的无病生存和总体生存明显优于肿瘤退化级别为2至3的患者。肿瘤分化、ycT 分期、免疫治疗和淋巴结退化是新辅助化疗病理反应的独立预测因素。我们进一步开发了一个评分系统来预测肿瘤退化级别。受试者工作特征曲线和决策曲线分析显示评分系统的预测性能良好。淋巴结退化可用作病理反应的预测因子。我们开发了一个评分系统来预测接受新辅助化疗的胃癌患者的治疗反应。基于预测因子的评分系统可为临床决策提供指导。版权所有 © 2023 Elsevier Inc.。保留所有权利。

Neoadjuvant chemotherapy has become the standard treatment for locally advanced gastric cancer. The tumor regression grade system is an effective and widely used tool for the evaluation of treatment response to neoadjuvant chemotherapy. However, whether tumor regression grade could be predicted using clinical characteristics is uncertain.A total of 287 locally advanced gastric cancer patients from 2014 to 2021 were retrospectively included. According to the College of American Pathologists' tumor regression grade system, patients were classified into response group (tumor regression grade 0-1) and non-response group (tumor regression grade 2-3). Associations between clinical characteristics and neoadjuvant chemotherapy response were performed by the logistic regression model. The Kaplan-Meier method was used to estimate the survival. A prediction scoring system was constructed based on the β coefficients of multivariate analysis. The receiver operating characteristic curve and decision curve analysis were used to evaluate the performance of the predictive scoring system.Survival analysis showed that patients with tumor regression grades 0 to 1 had significantly better disease-free survival and overall survival than the tumor regression grades 2 to 3. Tumor differentiation, ycT stage, immunotherapy, and lymph node regression were independent predictors of pathological response to neoadjuvant chemotherapy. We further developed a scoring system to predict the tumor regression grade. The receiver operating characteristic and decision curve analysis showed good predictive performance of the scoring system.Lymph node regression could be used as a predictor for pathological response. We developed a scoring system to predict the treatment response of patients with gastric cancer receiving neoadjuvant chemotherapy. The scoring system based on the predictors could provide guidance for making clinical decisions.Copyright © 2023 Elsevier Inc. All rights reserved.