| Objective: There is no uniform standard for preoperative evaluation of lymph node metastasis in early gastric cancer.Previous studies have shown that serotyping is an important clinicopathological indicator of gastric cancer,and extensive and in-depth studies have been conducted in advanced gastric cancer.The purpose of this study was to propose a new evaluation method for lymph node metastasis and to study the value of serotype for preoperative evaluation of lymph node metastasis in early gastric cancer.Materials and methods: this paper retrospectively analyzed the clinicopathological data of 335 patients with early gastric cancer diagnosed before surgery,divided the serotype of patients with early gastric cancer into normal type and reactive type,and compared the lymph node metastasis rates of the two groups.In addition,284 cases of early gastric cancer diagnosed by postoperative pathology were compared to verify the effectiveness of the former.Results: The rate of lymph node metastasis in patients with serose-reactive type in the preoperative diagnosis of early gastric cancer was significantly lower than that in patients with normal serose-reactive type,and the difference was statistically significant(p0.05).There were also significant differences in tumor size,invasion depth and lymph node dissection.The significant variables obtained by univariate analysis,tumor size,T staging and serotype were included in multivariate logistic regression analysis,and T staging(95%CI 2.640-6.895)(P=0.000)and serotype(95%CI 1.472-5.337)(P=0.002)were obtained.P<0.05 was an independent risk factor for lymph node metastasis in early gastric cancer.We further obtained the ROC curve(figure 3),the area under the surface(AUC value)was 0.799(95%Cl 0.738-0.860),and the sensitivity was 68.4% and the specificity was 77.0% calculated at the cut-off point.The above data were compared for prognostic factors.The size of the tumor was P=0.046,and the 5-year survival rate of the part less than 2cm was higher than that of the part greater than or equal to 2cm.The5-year survival rate of T1 a was higher than that of T1 b and higher than that of T2.The5-year survival rate of patients without lymph node metastasis was higher than that of patients with lymph node metastasis(P<0.000).Serotype P=0.026,the 5-year survival rate of patients with normal serotype was higher than that of patients with serotype reaction.All the above factors were P<0.05,which were prognostic factors.Will get classification variables was statistically significant variables in the COX proportional hazards regression model is analyzed,the results show in table 4,T staged(95%Cl,1.553-4.989)(P = 0.001),lymph node metastasis(95%Cl,1.362-6.770)(P = 0.007),all is the independent factors influencing the prognosis of early gastric cancer,and the classification of size(P = 0.221)are not independent factors affecting the prognosis.Postoperative pathological diagnosis of early gastric cancer cases as a comparison,the same comparison,get the same results.Conclusions: In the serotyping system of early gastric cancer,the rate of lymph node metastasis in patients with serose-reactive type was significantly higher than that in patients with normal serose-reactive type,and the preoperative evaluation of lymph node metastasis had an independent predictive effect.Therefore,patients with reactive serotype during the operation have higher risk of lymph node metastasis and poor prognosis.The scope of lymph node dissection can be appropriately expanded to achieve radical lymph node dissection and obtain long-term survival benefits.On the contrary,when the serotype is normal,the surgical scope can be appropriately narrowed to reduce postoperative complications without affecting the postoperative survival. |
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