Analysis Of Risk Factors Of Lymph Node Metastasis In Early Gastric Cancer And Construction And Validation Of Prediction Model

Objective:It is particularly important for the formulation of clinical treatment to calculate the status of lymph node metastasis in patients with early gastric cancer.The purpose of this study was to construct a nomogram to predict the risk of LNM in early gastric cancer before operation.Methods:This study included 292 patients with early gastric cancer who underwent radical resection of gastric cancer in the affiliated Hospital of Yangzhou University from February 2015 to February 2020.Univariate analysis and Logistic regression analysis were used to determine the independent risk factors of LNM in EGC.The independent risk factors are constructed into a nomogram,and the accuracy of the model is verified by C-Index and correction curve.Results: Among the 292 patients with early gastric cancer included in this study,48 had lymph node metastasis,and the positive rate of lymph nodes was about 16.44%.Univariate analysis showed that NLR,PLR,LMR,AFR,SII,age,histological classification,gross classification,were not associated with lymph node metastasis(p>0.05).Gender,tumor location,longest diameter of tumor,degree of differentiation,depth of invasion,nerve invasion,vascular invasion,PNI and SIRI were the risk factors of lymph node metastasis in patients with early gastric cancer(p<0.05).Multivariate Logistic regression analysis showed that tumor location,tumor size,PNI and SIRI were independent risk factors for LNM in EGC(p<0.05).These four risk factors were used to construct a nomogram to predict the risk of LNM in EGC.First,Bootstrap self-sampling was used for internal verification,and the C-index value was 0.814.Then through the correction curve,it was found that there was a good correlation between the LNM rate predicted by the model and the actual LNM rate.Conclusion: This study constructed a nomogram based on SIRI,PNI,tumor size and tumor location,which can accurately predict the risk of lymphatic metastasis of early gastric cancer,which is helpful to the formulation of clinical treatment strategy.