Construction and Analysis of Vascular or Nerve Invasion Models of Gastric Cancer Based on Clinicopathological Features
Objective To explore the risk factors of lymph blood vessel invasion(LBVI)or preineural invasion(PNI)in patients with gastric cancer,and to construct a nomogram model to predict the risk of LBVI or PNI.Methods The clinical and pathological data of 268 patients with gastric cancer admitted to Qinghai Provincial People's Hospital from May 2014 to March 2022 were collected.The risk factors of LBVI or PNI were screened by univariate and multivariate Logistic regression analysis.Based on the multivariate Logistic regres-sion analysis results,a nomogram model was constructed.The diagnostic efficacy of the nomogram model was evaluated by receiver operat-ing characteristics(ROC)curve and calibration curve,and the clinical benefit of the nomogram prediction model was analyzed by clinical decision analysis(DCA)curve.Results Among 268 patients with gastric cancer,119(44.4％)had LBVI or PNI,and 149(55.6％)had no LBVI or PNI.Univariate Logistic regression analysis showed that tumor diameter,differentiation degree,pathological stage,depth of invasion and number of lymph node metastasis were the risk factors for LBVI or PNI in patients with gastric cancer(P＜0.05).Multi-variate Logistic regression analysis showed that tumor diameter,differentiation degree and number of lymph node metastasis were independ-ent risk factors for LBVI or PNI in gastric cancer patients(P＜0.01).Based on the above three risk factors,the LBVI or PNI risk nomo-gram model was established.The area under the ROC curve of the model was 0.806,the sensitivity was 63.9％,and the specificity was 83.2％.The consistency index was 0.811,the mean absolute error value(MAE)was 0.016,and the Hosmer-Lemeshow test showed that P＞0.05.When the threshold probability of DCA curve was 0.08-0.97,the clinical net benefit rate of patients was higher.Conclusion Tumor diameter,differentiation degree and number of lymph node metastasis are independent risk factors for LBVI or PNI in patients with gastric cancer.The risk nomogram prediction model of LBVI or PNI based on risk factors has good prediction efficiency and clinical applicability,which is helpful to predict whether LBVI or PNI occurs in patients with gastric cancer.
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