Association Between Multiple Coagulation-related Factors And Lymph Node Metastasis In Patients With Gastric Cancer

Background:Patients with tumors generally present with accompanying activation of the coagulation system,which may be related to tumor stage.To our knowledge,few studies have examined the activation of the coagulation system in reference to lymph node metastasis within gastric cancer.This study aimed to investigate the correlation between multiple coagulation-related factors and lymph node metastasis in patients with gastric cancer in all patients of the gastric cancer and also investigate them under each tumor T stage.Materials and Methods:We retrospectively evaluated the relationship between lymph node metastasis and coagulation-related factors in 1128 patients with gastric cancer.We further analyzed influencing factors for lymph node metastasis and verified the predictive value of maximum amplitude(MA,a parameter of thromboelastography which is widely used to assess the strength of platelet-fibrinogen interaction in forming clots)in reference to lymph node metastasis.Results:Platelet levels were higher in patients with gastric cancer with lymph node metastasis than in the group without lymph node metastasis(264.10=177.50×109/L vs.231.98±57.68x109/L,P<0.001),MA values were higher in patients with gastric cancer with lymph node metastasis than in the group without lymph node metastasis(61.02±6.54 mm vs.56.39±5.62 mm,P<0.001),the same conclusions can be found in the studies under each tumor N stage.Moreover,tumor N stage was statistically significantly and positively correlated with platelet count(P<0.001)and MA value(P<0.001),all of which increased with the increase of tumor N stage,the same conclusions can be found in the studies under each tumor N stage.The MA value was an independent factor for lymph node metastasis(β=1.126,95%CI 1.075-1.178,P<0.001)and tumor N stage(p=0.087,95%CI 0.054-0.120,P<0.001)in patients with gastric cancer and the same conclusions can be found in the studies under each tumor N stage.MA value could be used to predict the presence of lymph node metastasis in patients with gastric cancer(AUC=0.705,P<0.001,95%CI 0.663-0.746).The cut-off value for the MA value in predicting lymph node metastasis in patients with gastric cancer was 54.950(sensitivity 0.821,specificity 0.514).Conclusion:We conclude that platelet level and MA value were positively correlated with lymph node metastasis and tumor N stage in all patients with gastric cancer as well as under each tumor T stage.MA value is an independent influencing factor for lymph node metastasis and tumor N stage in all patients with gastric cancer as well as under each tumor T stage.The MA value has important value in predicting the presence or absence of lymph node metastasis in patients with gastric cancer.