Analysis Of Risk Factors And Establishment Of Predictive Model For Lymph Node Metastasis Of Early Gastric Cancer

Objective:Determining the risk of lymph node metastasis(LNM)is crucial to the choice of the optimal treatment for early gastric cancer(EGC)patients 。 This study aims to investigate the relationship between lymph node metastasis and clinicopathological features of EGC,to determine the risk factors of lymph node metastasis,and to establish a risk prediction model to quantify the probability of LNM in EGC。Methods:We retrospectively collected the relevant clinicopathological data of 338 patients with early gastric cancer who received radical gastrectomy as initial treatment at the Second Affiliated Hospital of Nanchang University from March 2017 to March 2023.The risk factors identified in univariate analysis were included in multivariate logistic regression analysis,and then a nomogram model was established.Receiver operating characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the predictive value of the model.Results:Lymph node metastasis was found in 43 patients(12.7%)in this study,and submucosal carcinoma was more common(35/43).Multivariate logistic analysis showed that depth of invasion,differentiation,vascular invasion and suspicious lymph nodes on CT were independent risk factors for LNM,which were used to construct a nomogram model.The concordance index was 0.869 [95% CI:0.8006-0.9377],the corrected C-index was 0.857.The ROC curve,calibration curve and clinical decision curve all indicated that the model has good practical value.Conclusion:The results of this study showed that submucosal invasion,undifferentiated type,vascular invasion and suspicious lymph nodes on CT were independent risk factors for lymph node metastasis of early gastric cancer,and the prediction model of lymph node metastasis risk in early gastric cancer was established,providing a reference for clinical treatment decisions.