Assessment of Non-Tumor Liver Parenchyma Damage in Advanced Gastric Cancer Treatment with Transarterial Infusion Chemotherapy: A Study Using Imaging and Hepatic Injury Indicators

YiFan Jing Xuming Bai ^* Yong Jin ^*

• Second Affiliated Hospital of Soochow University, Suzhou, China

This study aims to assess non-tumor liver parenchyma damage in patients with advanced gastric cancer undergoing transarterial infusion chemotherapy, using imaging and hepatic injury indicators for evaluation. We retrospectively analyzed the clinical data of 52 patients with advanced gastric cancer treated with transarterial infusion chemotherapy at our center between July 2015 and July 2023. Pre-and post-treatment abdominal CT images and corresponding laboratory indices were collected. The liver-to-spleen (L/S) density ratio and spleen volume were measured using imaging post-processing software. Hepatic fibrosis indices, including APRI, FIB-4, Child-Pugh, and Albumin-Bilirubin (ALBI), were calculated from the laboratory data. Statistical analysis was performed using the Wilcoxon rank-sum test and paired t-test.The patients received an average of 2.80 cycles of transarterial infusion chemotherapy, with a mean duration of 8.3 weeks. After treatment, 76.92% of patients (40/52) showed a statistically significant reduction in the L/S density ratio compared to pre-treatment levels (1.23 ± 0.13 vs 1.12 ± 0.1, P < 0.01). Additionally, 73.1% of patients (38/52) experienced an increase in spleen volume, with a significant increase from 151,219.33 mm³ to 202,171.32 mm³ (P < 0.05).Pre-treatment hepatic fibrosis indices (APRI and FIB-4) were 0.19 ± 0.15 and 1.29 ± 0.88, respectively. Post-treatment, these indices significantly increased to 0.37 ± 0.27 and 2.24 ± 1.38 (P < 0.01 for both). Liver function scores showed no significant differences: ALBI scores changed from -2.7 ± 0.41 to -2.58 ± 0.43 (P > 0.05), and Child-Pugh scores changed from 5.31 ± 0.47 to 5.38 ± 0.64 (P > 0.05). In conclusion, transarterial infusion chemotherapy for advanced gastric cancer results in short-term damage to the non-tumor liver parenchyma, consistent with manifestations of hepatic steatosis, hepatic fibrosis, and hepatic sinusoidal obstruction syndrome. CT examination and hepatic injury indicators were useful for the early detection of drug-induced liver damage, even before laboratory abnormalities or clinical manifestations are observed.