早期胃癌患者淋巴结转移相关危险因素分析及建模

Analysis and modeling of risk factors related to lymph node metastasis in patients with early-stage gastric cancer

目的 分析相关危险因素,评估早期胃癌患者淋巴结转移风险,为早期胃癌患者非治愈性切除后辅助化疗提供指导。方法 对2014年1月—2021年6月在兰州大学第二医院接受胃癌根治性切除治疗的389例早期胃癌患者病历进行回顾性检索。收集相关因素,筛选出影响淋巴结转移的独立危险因素。随后,建立预测模型,并进行内部验证。结果 影响早期胃癌淋巴结转移的独立危险因素包括胃癌浸润深度(P=0.030)、肿瘤大小≥2 cm (P=0.015)、含有印戒细胞成分(P=0.012)以及淋巴管侵犯(P<0.001)。预测模型的曲线下面积为0.754。结论 以4个独立危险因素:浸润深度、肿瘤大小、含印戒细胞成分、淋巴管侵犯成功构建了用于早期胃癌患者预测淋巴结转移风险的模型,为临床制定个性化治疗方案提供了重要参考。

Objective To evaluate the risk of lymph node metastasis in patients with early gastric cancer via an analysis of risk factors,so as to sort patients with early-stage gastric cancer and provide guidance for adjuvant chemotherapy after endoscopic surgery.Methods A retrospective medical record search was performed for 389 patients with early-stage gastric cancer who underwent radical resection in the Second Hospital of Lanzhou University from January 2014 to June 2021.Relevant risk factors were collected,and univariate and multivariate analyses were performed to screen out independent risk factors affecting lymph node metastasis.Subsequently,a predictive model was built and validated internally.Results The model included four vari-ables significantly associated with lymph node metastasis:gastric cancer invasion depth(P=0.030),tumor size≥2 cm(P=0.015),presence of signet ring cell component(P=0.012)and lymphatic vessel invasion(P<0.001),and the predictive model demonstrated an area under the curve of 0.764.Conclusion A model for predicting the risk of lymph node metastasis in patients with early gastric cancer was successfully constructed based on four independent risk factors:depth of invasion,tumor size,signet ring cell components,and lymphatic vessel invasion,providing an important reference for clinical development of personalized treat-ment plans.