Department of Gastroenterology, the People's Hospital of Rizhao, Rizhao, Shandong Province, China.
Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
Medicine (Baltimore). 2023 Nov 17;102(46):e35891. doi: 10.1097/MD.0000000000035891.
To select an optimal treatment, it is crucial to evaluate the risk of lymph node metastasis (LNM) in patients with superficial esophageal squamous cell carcinoma (SESCC). The research aimed to explore more risk factors than before and construct a practical nomogram to predict LNM in patients with SESCC. We retrospectively reviewed 1080 patients diagnosed with esophageal cancer who underwent esophagectomy with lymphadenectomy between January 2013 and October 2021 at the Affiliated Hospital of Qingdao University. The clinical parameters, endoscopic features, and pathological characteristics of the 123 patients that were finally enrolled in this study were collected. The independent risk factors for LNM were determined using univariate and multivariate analyses. Using these factors, a nomogram was constructed to predict LNM. LNM was observed in 21 patients. Univariate analysis showed that the absence or presence of hypertriglyceridemia, tumor location, lesion size, macroscopic type, invasion depth, differentiation, absence or presence of lymphovascular invasion (LVI), and perineural invasion were significantly associated with LNM. According to the multivariate analysis, hypertriglyceridemia, tumors located in the lower thoracic esophagus, lesion size > 20 mm, submucosal invasion, and LVI were independent risk factors for LNM. A nomogram was established using these 5 factors. It showed good calibration and discrimination. Hypertriglyceridemia, tumors located in the lower thoracic esophagus, lesion size > 20 mm, submucosal invasion, and LVI were independent risk factors for LNM. A nomogram was constructed using these 5 factors. This model can help clinicians assess the risk of LNM in patients with SESCC for optimal treatment selection.
为了选择最佳的治疗方案，评估浅表性食管鳞状细胞癌（SESCC）患者的淋巴结转移（LNM）风险至关重要。本研究旨在探索更多的风险因素，并构建一个实用的列线图来预测 SESCC 患者的 LNM。我们回顾性分析了 2013 年 1 月至 2021 年 10 月期间在青岛大学附属医院接受食管癌切除术和淋巴结切除术的 1080 例食管癌患者的临床资料、内镜特征和病理特征。最终纳入本研究的 123 例患者的临床参数、内镜特征和病理特征被收集。采用单因素和多因素分析确定 LNM 的独立危险因素。利用这些因素构建了一个预测 LNM 的列线图。共观察到 21 例 LNM。单因素分析显示，有无高甘油三酯血症、肿瘤位置、病变大小、大体类型、浸润深度、分化、有无淋巴血管侵犯（LVI）和神经周围侵犯与 LNM 显著相关。多因素分析显示，高甘油三酯血症、肿瘤位于胸下段、病变大小＞20mm、黏膜下浸润和 LVI 是 LNM 的独立危险因素。根据这 5 个因素建立了一个列线图，显示了良好的校准和判别能力。高甘油三酯血症、肿瘤位于胸下段、病变大小＞20mm、黏膜下浸润和 LVI 是 LNM 的独立危险因素。根据这 5 个因素建立了一个列线图，该模型可以帮助临床医生评估 SESCC 患者的 LNM 风险，以便为最佳治疗选择提供参考。
