Risk Factors and Establishment of Prediction Model for Preoperative Lymph Node Staging Deficiency in Gastric Cancer
10.3971/j.issn.1000-8578.2023.22.1254
- VernacularTitle:胃癌术前淋巴结分期不足的危险因素及预测模型的建立
- Author:
Shuxiang DU
1
;
Zhen GUO
;
Zilai CHEN
;
Shangxin WANG
;
Gang WU
Author Information
1. Department of Gastrointestinal Surgery, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
- Publication Type:Research Article
- Keywords:
Gastric cancer;
Thin-layer multistage enhanced CT;
Preoperative N-stage deficiency;
Risk factors;
Predictive model
- From:
Cancer Research on Prevention and Treatment
2023;50(5):498-504
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors of preoperative lymph node staging (N-stage) deficiency in gastric cancer and establish a preoperative assessment model to assist in predicting preoperative N-stage. Methods A retrospective method was used to analyze the clinicopathological data of 268 patients with gastric cancer. The patients routinely underwent preoperative thin-section enhanced CT to assess preoperative N-stage. Results The risk factors for preoperative N-stage deficiency were analyzed in combination with postoperative pathological findings. Multifactorial logistic regression analysis was performed to determine influencing factors, and Kaplan-Meier analysis was used to plot the survival curves of preoperative N-stage accurate group and deficiency group. The nomogram plot and ROC curves of the prediction model were drawn using the R package. AUC, 95%CI, sensitivity, and specificity were calculated. Results Age, BMI, poor differentiation, and Lauren's classification as diffuse were independent risk factors for preoperative N-stage deficiency in gastric cancer (P < 0.05). Prognostic survival was significantly worse in the preoperative N stage-inadequate group than that in the accurate group (P=0.041). The AUC area was 0.935, with a sensitivity of 85.9% and specificity of 96.9%. Conclusion Young age, high BMI, poor differentiation, and Lauren's classification as diffuse are independent risk factors for preoperative N-stage deficiency. The established preoperative assessment model based on age, BMI, differentiation degree, and Lauren's classification in this study has relatively high credibility.
