Clinicopathological characteristics of early gastric cancer with different level of undifferentiated component and nomogram to predict lymph node metastasis

被引:2
|
作者
Li, Chenyu [1 ]
Xie, Suling [2 ]
Chen, Dan [2 ]
Zhang, Jingwen [1 ,2 ]
Zhang, Ning [3 ]
Mu, Jinchao [1 ]
Gong, Aixia [1 ]
机构
[1] Dalian Med Univ, Affiliated Hosp 1, Dept Gastroenterol, Dalian, Peoples R China
[2] Dalian Med Univ, Affiliated Hosp 1, Dept Pathol, Dalian, Peoples R China
[3] Dalian Med Univ, Affiliated Hosp 1, Dept Geriatr Med, Dalian, Peoples R China
来源
FRONTIERS IN SURGERY | 2023年 / 10卷
关键词
early gastric cancer; lymph node metastasis; mixed type; predicting; nomogram; HISTOLOGICAL MIXED-TYPE; ENDOSCOPIC RESECTION; RISK; FEASIBILITY;
D O I
10.3389/fsurg.2023.1097927
中图分类号
R61 [外科手术学];
学科分类号
摘要
BackgroundFew studies showed that mixed type early gastric cancer (EGC) relates to higher risk of lymph node metastasis. We aimed to explore the clinicopathological feature of GC according to different proportions of undifferentiated components (PUC) and develop a nomogram to predict status of lymph node metastasis (LNM) in EGC lesions. MethodsClinicopathological data of the 4,375 patients who underwent surgically resection for gastric cancer in our center were retrospectively evaluated and finally 626 cases were included. We classified mixed type lesions into five groups (M1:0% < PUC <= 20%, M2:20%<PUC <= 40%, M3:40%<PUC <= 60%, M4:60%<PUC <= 80%, M5:80%<PUC < 100%). Lesions with 0% PUC were classified as pure differentiated group (PD) and lesions with 100% PUC were classified as pure undifferentiated group (PUD). ResultsCompared with PD, LNM rate was higher in group M4 and group M5 (p < 0.05 after Bonferroni correction). Differences of tumor size, presence of lymphovascular invasion (LVI), perineural invasion and invasion depth also exist between groups. No statistical difference of LNM rate was found in cases who met the absolute endoscopic submucosal dissection (ESD) indications for EGC patients. Multivariate analysis revealed that tumor size over 2 cm, submucosa invasion to SM2, presence of LVI and PUC level M4 significantly predicted LNM in EGC. With the AUC of 0.899(P < 0.05), the nomogram exhibited a good discrimination. Internal validation by Hosmer-Lemeshow test showed a good fitting effect in model (P > 0.05). ConclusionPUC level should be considered as one of the predicting risk factors of LNM in EGC. A nomogram that predicts the risk of LNM in EGC was developed.
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页数:10
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