Correlation Analysis Between Clinical Characteristics And Differentiation Of Early Gastric Cancer

Objective:By studying the correlation between the degree of tissue differentiation and clinical characteristics of early gastric cancer(EGC),it provides a more accurate theoretical basis for clinical treatment plans.Methods:A total of 143 patients with EGC confirmed by pathology after endoscopic submucosal dissection(ESD)or surgery in the first Hospital of Shanxi Medical University from May 1,2018 to December 31,2022 were selected.According to the degree of histological differentiation,the patients were divided into two groups:differentiated group(n = 112)and undifferentiated group(n = 31).The data of sex,age,height,weight,body mass index(BMI),smoking history,drinking history,tumor location,tumor size,tumor shape,tumor hue change,depth of invasion,ulcer,vascular invasion,lymph node metastasis,atrophy,neutrophil count(N),lymphocyte count(L),platelet count(Plt),Neutrophil to lymphocyte ratio(NLR),Platelet to lymphocyte ratio(PLR)were collected and and carried out univariate analysis.Taking the degree of differentiation as a dependent variable and the above indicators with statistically significant differences as covariables,a multi-factor Logistic regression equation was constructed.Drawing ROC curve for variables with meaningful regression analysis.Results:1.Univariate analysis showed that there were statistically significant differences in age(P=0.000),hue change(P=0.028),depth of invasion(P=0.000),ulcer(P=0.000),lymph node metastasis(P=0.000),Plt(P=0.039)and NLR(P=0.037)between the two groups(P<0.05);there were no significant difference in other variables(P>0.05).2.The degree of differentiation was taken as the dependent variable,and the statistically significant factors(age,hue change,depth of invasion,ulcer,lymph node metastasis,Plt,NLR)were used as covariables to construct the multivariate Logistic regression equation.There were statistically significant differences in age(OR=0.928,95%CI 0.879-0.980,P=0.007),hue change of(OR=10.747,95%CI2.325-49.686,P=0.002),depth of invasion(OR=7.259,95%CI 2.241-23.512,P=0.001),ulcer(OR=4.463,95%CI 1.201-16.589,P=0.026),lymph node metastasis(OR=9.346,95%CI 2.144-40.732,P=0.003)between the two groups(P<0.05).The older the age,the more differentiated EGC tends to be.The degree of EGC differentiation tends to be undifferentiated type when the tumor has following characteristics: white hue,depth of invasion to submucosa,ulcer and lymph node metastasis,which are the risk factors of undifferentiated EGC.There were no significant difference in Plt and NLR between the two groups(P>0.05).3.The multivariate Logistic regression equation showed that age,hue change,depth of invasion,ulcer and lymph node metastasis were related to the degree of EGC differentiation.By drawing the ROC curve,the following conclusions can be drawn:the AUC of depth of invasion was 0.674(95%CI 0.566-0.781,P=0.003<0.05),the critical value was 1(submucosa),the sensitivity is 67.7%,and the specificity is67.0%;the AUC of ulcer(yes / no)was 0.677(95%CI 0.579-0.774,P=0.003<0.05),the critical value was 1(yes),the sensitivity was 87.1%,and the specificity was48.2%.This suggests that the depth of tumor invasion to submucosa and the presence of ulcer can be used as predictors of undifferentiated EGC.There were no predictive value for age(AUC=0.296<0.5,P= 0.001<0.05),hue change(P=0.151>0.05)and lymph node metastasis(P=0.082>0.05).Conclusion:The degree of differentiation of EGC is mainly related to age,hue change,depth of invasion,ulcer and lymph node metastasis.The older the age,the more differentiated EGC tends to be.Hue whitening,depth of invasion to submucosa,ulcer and lymph node metastasis are independent risk factors of undifferentiated EGC.The depth of tumor invasion to submucosa and ulcer can be used as predictive indicators of undifferentiated EGC.