Analysis Of Risk Factors Related To The Depth Of Invasion In Esophageal Carcinoma

Background and ObjectiveEsophageal cancer is a very common tumor.Accurately assessing the depth of esophageal cancer invasion before surgery is particularly important for the choice of treatment.In recent years,tumor length,systemic inflammatory indicators such as platelet-lymphocyte ratio(PLR),neutrophil-lymphocyte ratio(NLR),lymphocytemonocyte ratio(LMR),and pathological characteristics of esophageal cancer such as T grade and M grade The relevance of has been extensively studied.This study analyzed the factors related to the depth of esophageal cancer invasion to provide a more accurate method for judging the depth of esophageal cancer invasion.MethodsA retrospective analysis of patients who were diagnosed with esophageal cancer through gastroscopy and pathological examination at the Second Affiliated Hospital of Zhengzhou University from June 2014 to June 2020,and undergoing surgical treatment.Among them,there were 102 males(58.6%)and 72 females(41.4%),a total of 174 cases(174 lesions).Observe and record the age,gender,tumor location,tumor size,platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR)and postoperative pathological diagnosis results of patients who meet the inclusion.According to the results of postoperative pathological diagnosis,these patients were divided into two groups with tumor invasion depth ≤ SM1 group and> SM groups to explore the risk factors that affect the depth of esophageal cancer invasion.Apply SPSS25.0 software.Quantitative data is expressed as mean ± standard deviation((?)±s),and independent sample t-test is used to compare the two groups.Counting data is expressed in terms of rate or composition ratio,and the comparison between the two groups is performed by chi-square(χ2)test.In univariate analysis,variables with statistically significant differences were included in the multivariate logistic regression analysis.According to logistic regression analysis and receiver operating characteristic curve(ROC curve),the best cutoff value,area under the curve(AUC),sensitivity,specificity and other diagnostic indicators of independent influencing factors are calculated.The test level is α=0.05,and the difference is statistically significant with P<0.05.Results1.The results of univariate analysis showed that the depth of tumor invasion ≤SM1 group and> SM1 group patients,PLR(t=-5.574,P<0.001),tumor length(t=-5.176,P<0.001),NLR(t=-3.75,P<0.001)The difference was statistically significant.The PLR,tumor size,and LMR values of patients in the tumor invasion depth> SM1 group were higher than those in the tumor invasion depth ≤ SM1 group.Differences in age(t=0.849,P=0.397),tumor location(χ2=1.836,P=0.399),gender(χ2=0.787,P=0.375),LMR(t=1.074,P=0.284)between the two groups There is no statistical significance.2.In the independent sample t test,the differences in the mean of PLR,NLR and tumor length between the two groups were statistically significant.They were included in the multivariate logistic regression analysis.The results showed that high PLR(P=0.001)was an independent risk factor for the depth of invasion of esophageal cancer>SM1.For every increase in PLR,the probability of the depth of invasion of esophageal cancer exceeding SM1 increased by 1.017 times(≤SM1 vs>SM1:OR=1.017,95%CI=1.007-1.028,P=0.001);larger tumor length(P < 0.001)is an independent risk factor for esophageal cancer invasion depth>SM1.Each unit of tumor length increases the probability that the tumor invasion depth exceeds SM1 1.596 times(≤SM1 vs>SM1: OR=1.596,95%CI=1.254-2.032,P<0.001);NLR(P=0.819)is not related to the depth of tumor invasion3.The diagnostic value of PLR and tumor length for the depth of invasion of esophageal cancer: According to the ROC curve,the best cutoff value of PLR is 145.47,AUC is 0.74,95%CI: 0.667-0.813,P<0.001;for depth of invasion > SM1,the sensitivity is 0.495 and the specificity is 0.883.The best cutoff value for tumor size was 3.1cm,AUC was 0.796,95%CI: 0.698-0.841,P<0.001;the sensitivity to depth of invasion >SM1 was 0.722,and the specificity was 0.714.In the combined diagnosis of the two,the AUC was 0.812,95%CI: 0.748-0.876,P<0.001;the sensitivity to depth of invasion >SM1 was 0.866,and the specificity was 0.61.Conclusions1.High PLR and tumor length are independent risk factors for esophageal cancer invasion depth > SM1.2.Both have good accuracy in the diagnosis of the depth of esophageal cancer invasion,and the combination of the two can further improve the accuracy and provide a more reliable basis for the choice of treatment methods.