Lymph node metastasis status after ESD in patients with colorectal neuroendocrine neoplasms and its correlation with SATB2
Objective To investigate the lymph node metastasis status after endoscopic submucosal dissection(ESD)in patients with colorectal neuroendocrine neoplasms(NENs)and its correlation with special AT-rich sequence binding protein 2(SATB2).Methods A total of 158 patients with colorectal NENs admitted in Hanzhong Central Hospital from January 2018 to January 2023 were included and treated with ESD.The surgical and follow-up results of all patients were recorded,including en bloc resection rate,positive margin rate,and lymph node metastasis rate.According to the lymph node metastasis during the follow-up period,the patients were divided into metastasis group and control group.The clinical data of the two groups were recorded and compared.Binary Logistic regression analysis was used to analyze the risk factors affecting lymph node metastasis after ESD in patients with colorectal NENs.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of SATB2 for lymph node metastasis after ESD.Results The ESD of 158 patients was en bloc resection,the en bloc resection rate was 100.00%,14 patients(8.86%)had positive resection margin.During the follow-up period,21 cases(13.29%)with lymph node metastasis were included in the metastasis group,and 137 cases without lymph node metastasis were inclueed in the control group.There were significant differences in tumor stage,tumor diameter,lymphatic invasion and SATB2 positive between the two groups(P<0.05).The results of binary Logistic regression analysis showed that tumor stage,tumor diameter and lymphatic invasion were risk factors for lymph node metastasis after ESD in patients with colorectal NENs,and SATB2 positive was a protective factor(P<0.05).ROC curve showed that the area under curve(AUC)of SATB2 in predicting lymph node metastasis after ESD in patients with colorectal NENs was 0.747(95%CI 0.626-0.867),the sensitivity was 57.69%,and the specificity was 91.67%.Conclusion The occurrence of lymph node metastasis after ESD in patients with colorectal NENs is related to tumor stage,tumor diameter,lymphatic invasion,and SATB2 expression.SATB2 can be used as an effective indicator for evaluating lymph node metastasis in patients.
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