Study On Risk Factors And Treatment Strategies Of Lymph Node Metastasis In Early Gastric Cancer

Objective:At present,there is no agreement on the risk factors of lymph node metastasis in early gastric cancer.In order to explore which risk factors are associated with lymph node metastasis and evaluate the risk of lymph node metastasis in patients,an appropriate treatment plan for patients with early gastric cancer can be provided.Methods:The clinicopathological characteristics of 117 patients who underwent laparoscopic radical gastrectomy in the first affiliated Hospital of Shaoxing University of Arts and Sciences from January 2015 to October 2021 and whether biochemical indexes such as serum albumin were independent risk factors for lymph node metastasis were retrospectively analyzed.A regression model for predicting lymph node metastasis was established and verified by univariate and multivariate analysis.The 117 patients were randomly divided into a training set(88 cases)and a validation set(29 cases),and the area under the receiver operating characteristic curve was used to evaluate the discriminative ability of the model.The model calibration ability was determined by the model calibration graph and the Hosmer-Lemeshow test,respectively.to evaluate.Results:14.8% of patients with early gastric cancer had lymph node metastasis,among which the lymph node metastasis rate of intramucosal cancer was 2.7%(1/37),and the lymph node metastasis rate of submucosal cancer was 23.5%(12/51).According to the analysis results of chi-square test and corrected chi-square test,it was concluded that the depth of invasion(P=0.007),presence or absence of ulcer(P=0.01)were risk factors for lymph node metastasis.Age,gender,tumor size and other related factors had no significant difference with lymph node metastasis in early gastric cancer(P>0.05).The receiver operating characteristic curve areas for the training and validation sets were 0.789(95%CI,0667-0.902)and 0.652(95%CI,0.429-0.875),respectively.Conclusions:A binary logistic regression model for risk factors of lymph node metastasis of early gastric cancer was established and verified.Depth of invasion,ulcer were independent risk factors of lymph node metastasis of early gastric cancer.