Abstract
ObjectiveMultidetector-row computed tomography (MDCT) and serum tumor biomarkers are commonly used to evaluate the preoperative lymph node metastasis and the clinical staging of gastric cancer (GC). This study intends to evaluate the clinical predictive value of MDCT and serum tumor biomarkers in lymph node metastasis of GC.MethodsThe clinicopathologic data of 445 GC patients who underwent radical gastrectomy were retrospectively analyzed to evaluate the diagnostic value of MDCT and serum tumor biomarkers in lymph node metastatic staging of GC before surgery.ResultsWith the multinomial logistic regression analysis, the independent relative factors of lymph node metastasis of GC were identified as tumor size, depth of tumor invasion, vessel invasion, vascular embolus, and soft tissue invasion. The optimal critical value of the short diameter of lymph nodes detected by MDCT scanning for evaluation of preoperative lymph node metastasis was 6.0 mm, with 75.7% as predictive accuracy of lymph node metastasis compared to the postoperative pathological results of GC patients. In addition, the critical value of the short diameter of lymph nodes combined with serum tumor biomarkers [including carbohydrate antigen (CA)-724 and CA-199] could show an enhancement of predictive sensitivity of lymph node metastasis (up to 89.3%) before surgery.ConclusionsMDCT combined with serum tumor biomarkers should be adopted to improve preoperative sensitivity and accuracy of lymph node metastasis for GC patients.
Highlights
The incidence of gastric cancer (GC) has decreased in recent decades; it remains one of the most common fatal disease in the world [1]
Tumor invasion depth and distant metastasis are important factors affecting the prognosis of GC patients
The tumor size and depth of tumor invasion can be well evaluated by endoscopic ultrasonography before surgery [12]
Summary
The incidence of gastric cancer (GC) has decreased in recent decades; it remains one of the most common fatal disease in the world [1]. Lymph node metastasis is one of the most important independent risk factors that can negatively affects the prognosis of patients with GC [2,3]. Bai et al Optimal diagnosis for lymph node metastasis of gastric cancer node metastasis is the key to giving important assistance for the preliminary assessment of the optimal therapy mode of tumors to improve the prognosis of GC patients. Multidetector-row computed tomography (MDCT) is one of the most practical methods for accurately detecting the extent of lymph node involvement in GC before surgery. MDCT is superior to other physical examination methods for the initial assessment of lymph node metastatic staging of GC before surgery due to its higher sensitivity and specificity [4,5]. Several studies have been demonstrated that serum tumor biomarkers provide some key markers to lymph node metastasis in GC [6,7,8]
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