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Characteristics of lymph node stations/basins metastasis and construction and validation of a preoperative combination prediction model that accurately excludes lymph node metastasis in early gastric cancer

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Chinese Journal of Cancer Research 2022年第5期34卷 519-532页

作者： Mengyu Feng Jingtao Wei Ke Ji Yinan Zhang Heli Yang Xiaojiang Wu Ji Zhang Zhaode Bu Jiafu Ji Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Center of Gastrointestinal CancerPeking University Cancer Hospital&InstituteBeijing 100142China

Objective:To explore the candidate indications for function-preserving curative gastrectomy and sentinel lymph node navigation surgery in early gastric cancer(EGC).Methods:The clinicopathological data of 561 patients with EGC who underwent radical gastrectomy for gastric cancer at Peking University Cancer Hospital from November 2010 to November 2020 with postoperative pathological stage pT1 and complete examination data,were ***’s Chi-square test was used and binary logistic regression was employed for univariate and multivariate *** analysis of multiple risk and protective factors for lymph node metastasis(LNM)of EGC was performed.A negative predictive value(NPV)combination model was built and ***:LNM occurred in 85 of 561 patients with EGC,and the LNM rate was 15.15%.NPV for LNM reached 100%based on three characteristics,including ulcer-free,moderately well differentiation and patientlymphatic basin metastasis,multivariate analysis showed that the metastatic proportion of the left gastric artery lymphatic basin was significantly higher in male patients compared with female patients(65.96%vs.38.89%,Plymphatic basin metastasis in patients with a maximum tumor diameter>2 cm was significantly greater than that noted in patients with a maximum tumor diameter≤2 cm(60.78%vs.28.13%,Pbasins metastasis will facilitate precise lymph node *** NPV for LNM reaches 100%based on the following two conditions:young and middle-aged EGC patients,well-differentiated tumors,and without ulcers;or well-differentiated tumors,without ulcers,and tumors located in the proximal *** findings can be used as the recommended indications for functionpreserving curative gastrectomy and sentinel lymph node navigation surgery.

关键词： Early gastric cancer lymph node metastasis lymphatic basin negative predictive value function-preserving curative gastrectomy with lymphatic basin dissection

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Identification of lymph node metastasis by computed tomography in early gastric cancer

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Chinese Journal of Cancer Research 2021年第6期33卷 671-681页

作者： Jingtao Wei Yinan Zhang Zhilong Wang Xiaojiang Wu Ji Zhang Zhaode Bu Jiafu Ji Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Gastrointestinal Cancer CenterPeking University Cancer Hospital&InstituteBeijing 100142China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of RadiologyPeking University Cancer Hospital&InstituteBeijing 100142China

Objective:Lymph node status is critical when selecting treatment methods for patients with early gastric cancer(EGC).The aim of this study was to assess the diagnostic value of computed tomography(CT)for detection of lymph node metastasis(LNM)in patients with ***:We retrospectively analyzed patients who had pathologically confirmed EGC between November2010 and January *** 1:1 propensity score matching,65 patients with LNM and 65 patients without LNM were retained for *** long diameter(LD)and short diameter(SD)of all visualized lymph nodes in all stations were *** diagnostic value of LNM was assessed with receiver operating characteristic ***:Among 130 patients,we found a total of 558 lymph nodes on the CT *** the diagnostic indicators,the number,sum of LD and sum of SD of lymph nodes greater than 3 mm had better *** areas under the curve were all greater than *** for different regions,the optimal cutoff values of number,the sum of LD and sum of SD were determined as follows:overall,≥4,19.9 mm and 13.5 mm;left gastric artery basin,≥3,15.7 mm and 8.6 mm;right gastroepiploic artery basin,≥2,8.6 mm and 7.0 ***:CT is valuable for diagnosing LNM in EGC *** number,sum of LD and sum of SD of lymph nodes greater than 3 mm are preferable *** regional lymph nodes have different optimal criteria for predicting LNM in ECG patients.

关键词： Computed tomography lymphatic metastasis early gastric cancer lymphatic basin

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