早期胃癌淋巴结转移的预测模型：迈向个体化淋巴结清扫术。
A prediction model for lymph node metastasis in early-stage gastric cancer: Toward tailored lymphadenectomy.
作者信息
Kim Su Mi, Lee Hyuk, Min Byung-Hoon, Kim Jae J, An Ji Yeong, Choi Min-Gew, Bae Jae Moon, Kim Sung, Sohn Tae Sung, Lee Jun Ho
机构信息
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
出版信息
J Surg Oncol. 2019 Sep;120(4):670-675. doi: 10.1002/jso.25628. Epub 2019 Jul 13.
BACKGROUND
The aim of this study was to develop a prediction model for the presence and location of lymph node metastasis (LNM) in early gastric cancer.
METHOD
We reviewed medical records of 4 929 patients who underwent radical gastrectomy for early gastric cancer. Variables of age, sex, lymphatic invasion, depth of invasion, location, gross type, differentiation, and tumor size were analyzed. Logistic regression analysis was used to determine independent predictors of LNM at each LN station.
RESULT
Overall incidence of LNM was 9.1% (448/4 929 patients). For the presence of LNM, risk factors of age, sex, lymphatic invasion, depth of invasion, anatomical part, gross ulceration, size, and tumor differentiation were significantly associated with LNM. The area under the curve (AUC) for predicting LNM after validation was 0.834 for the test set. For the location of LNM, age, sex, lymphatic invasion, depth of invasion, anatomical part, circumferential portion, gross type, differentiation, and tumor size were significantly associated with LNM. The AUC of each LN station was favorable with the test set.
CONCLUSION
Predicting the location of metastatic LNs appeared to be possible in patients with early gastric cancer.
背景
本研究旨在建立早期胃癌淋巴结转移（LNM）的存在及位置的预测模型。
方法
我们回顾了4929例行早期胃癌根治性胃切除术患者的病历。分析了年龄、性别、淋巴管侵犯、浸润深度、位置、大体类型、分化程度和肿瘤大小等变量。采用逻辑回归分析确定各淋巴结站LNM的独立预测因素。
结果
LNM的总体发生率为9.1%（448/4929例患者）。对于LNM的存在，年龄、性别、淋巴管侵犯、浸润深度、解剖部位、大体溃疡、大小和肿瘤分化等危险因素与LNM显著相关。验证后预测LNM的曲线下面积（AUC）在测试集中为0.834。对于LNM的位置，年龄、性别、淋巴管侵犯、浸润深度、解剖部位、圆周部分、大体类型、分化程度和肿瘤大小与LNM显著相关。各淋巴结站的AUC在测试集中表现良好。
结论
早期胃癌患者似乎有可能预测转移淋巴结的位置。
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