Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, PR China.
Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
Abdom Radiol (NY). 2023 Apr;48(4):1227-1236. doi: 10.1007/s00261-023-03848-7. Epub 2023 Feb 18.
A different treatment was used when peritoneal metastases (PM) occurred in patients with gastric cancer (GC). Certain cancers' peritoneal metastasis could be predicted by the cardiophrenic angle lymph node (CALN). This study aimed to establish a predictive model for PM of gastric cancer based on the CALN.
Our center retrospectively analyzed all GC patients between January 2017 and October 2019. Pre-surgery computed tomography (CT) scans were performed on all patients. The clinicopathological and CALN features were recorded. PM risk factors were identified via univariate and multivariate logistic regression analyses. The receiver operator characteristic (ROC) curves were generated using these CALN values. Using the calibration plot, the model fit was assessed. A decision curve analysis (DCA) was conducted to assess the clinical utility.
126 of 483 (26.1%) patients were confirmed as having peritoneal metastasis. These relevant factors were associated with PM: age, sex, T stage, N stage, enlarged retroperitoneal lymph nodes (ERLN), CALN, the long diameter of the largest CALN (LD of LCALN), the short diameter of the largest CALN (SD of LCALN), and the number of CALNs (N of CALNs). The multivariate analysis illustrated that the LD of LCALN (OR = 2.752, p < 0.001) was PM's independent risk factor in GC patients. The area under the curve (AUC) of the model was 0.907 (95% CI 0.872-0.941), demonstrating good performance in the predictive value of PM. There is excellent calibration evident from the calibration plot, which is close to the diagonal. The DCA was presented for the nomogram.
CALN could predict gastric cancer peritoneal metastasis. The model in this study provided a powerful predictive tool for determining PM in GC patients and helping clinicians allocate treatment.
胃癌（GC）患者发生腹膜转移（PM）时采用不同的治疗方法。某些癌症的腹膜转移可以通过心膈角淋巴结（CALN）来预测。本研究旨在建立基于 CALN 的胃癌腹膜转移预测模型。
我们中心回顾性分析了 2017 年 1 月至 2019 年 10 月间所有 GC 患者。所有患者均行术前计算机断层扫描（CT）检查。记录临床病理和 CALN 特征。通过单因素和多因素逻辑回归分析确定 PM 的危险因素。使用这些 CALN 值生成接收器操作特征（ROC）曲线。使用校准图评估模型拟合度。通过决策曲线分析（DCA）评估临床实用性。
483 例患者中，有 126 例（26.1%）被证实为腹膜转移。这些相关因素与 PM 相关：年龄、性别、T 分期、N 分期、腹膜后淋巴结肿大（ERLN）、CALN、CALN 最大长径（LCALN 的 LD）、CALN 最大短径（LCALN 的 SD）和 CALN 数量（CALN 的 N）。多因素分析表明，LCALN 的 LD（OR=2.752，p<0.001）是 GC 患者 PM 的独立危险因素。模型的曲线下面积（AUC）为 0.907（95%CI 0.872-0.941），表明在预测 PM 方面具有良好的性能。校准图显示出极好的校准，接近对角线。DCA 为该列线图提供了结果。
CALN 可预测胃癌腹膜转移。本研究中的模型为确定 GC 患者的 PM 提供了一个强大的预测工具，并帮助临床医生分配治疗方案。
