| Objective Esophageal cancer is highly malignant and has a poor prognosis.Lymph node metastasis and the number of positive lymph nodes are one of the important reasons that affect the prognosis of patients.Recurrent laryngeal lymph nodes are most common metastatic sites of thoracic esophageal cancer.Some researchers believe that cleaning the lymph nodes of the recurrent laryngeal nerve can significantly improve the patient’s prognosis,but some scholars believe that blindly expanding the scope of lymph node dissection will destroy the function of negative lymph nodes and may easily cause complications such as hoarseness and drinking choking.In order to explore the characteristics and rules of lymph node metastasis of the recurrent laryngeal nerve in thoracic esophageal squamous cell carcinoma,and to more accurately determine the nature of the lymph node of the recurrent laryngeal nerve,we built a predictive model based on the patient’s pathological parameters and imaging findings,with a view to individualize Treatment provides more basis.Methods A retrospective analysis of 89 patients with thoracic esophageal squamous cell carcinoma admitted to Tangshan People’s Hospital from January 2014 to January 2017 was used as a modeling set.According to the postoperative pathological results,the patients were divided into metastatic and non-metastatic groups.Related factors affecting the occurrence of lymph node metastasis to the recurrent laryngeal nerve.According to the weight of risk factors,build a risk model.At the same time,a continuous collection of 47 patients from the affiliated hospital of North China University of Technology from February 2017 to December 2018 was used as the verification set,and the prediction performance of the model was externally verified.Results 1 Single factor analysis showed that the tumor location,degree of differentiation,depth of invasion,subcarcinoma lymph node metastasis,lymph node SUV value,and CT lymph node metastasis signs are the risk factors affecting the occurrence of lymph node metastasis in the recurrent laryngeal nerve.2 Incorporating all the meaningful indicators in the single factor analysis into logistic regression analysis showed that the tumor location,degree of differentiation,depth of invasion,lymph node SUV value and signs of lymph node metastasis under CT are independent risks that affect the occurrence of lymph node metastasis to the recurrent laryngeal nerve Factors.3 Combined with independent risk factors,establish a prediction model: Pprediction=-0.754-1.347X1-1.361X2 + 1.282X3 + 3.380X4 + 1.912X5（X1: tumor location,X2: degree of differentiation,X3: depth of invasion,X4: lymph node SUV value,X5: signs of lymph node metastasis under CT）.4 Establish the ROC curve according to the prediction model: the maximum Youden index of the ROC curve is 0.710,the cutoff value is 0.662,the sensitivity is 70.9%,the specificity is 99.1%,and the area under the curve is 0.918.5 After entering the prediction model to test the prediction efficiency of the model,it was found that the area under the ROC curve was 0.79,and the Hosmer-Lemeshow goodness-of-fit test showed that χ2 = 1.52,P=0.93.The model has good fitting validity and high predictive value.Conclusions There are many high-risk factors that affect the lymph node metastasis of the recurrent laryngeal nerve in thoracic esophageal squamous cell carcinoma,and clinical evaluation should be performed effectively.The prediction model constructed in this study has good evaluation efficiency and has certain clinical application value.Figure3;Table2;Reference135... |
