Abstract
BackgroundLymph node metastasis (LNM) is a well-established prognostic factor for colon cancer. Preoperative LNM evaluation is relevant for planning colon cancer treatment. The aim of this study was to construct and evaluate a nomogram for predicting LNM in primary colon cancer according to pathological features.Patients and MethodsSix-hundred patients with clinicopathologically confirmed colon cancer (481 cases in the training set and 119 cases in the validation set) were enrolled in the Affiliated Cancer Hospital of Guangxi Medical University from January 2010 to December 2019. The expression of molecular markers (p53 and β-catenin) was determined by immunohistochemistry. Multivariate logistic regression was used to screen out independent risk factors, and a nomogram was established. The accuracy and discriminability of the nomogram were evaluated by consistency index and calibration curve.ResultsUnivariate logistic analysis revealed that LNM in colon cancer is significantly correlated (P <0.05) with tumor size, grading, stage, preoperative carcinoembryonic antigen (CEA) level, and peripheral nerve infiltration (PNI). Multivariate logistic regression analysis confirmed that CEA, grading, and PNI were independent prognostic factors of LNM (P <0.05). The nomogram for predicting LNM risk showed acceptable consistency and calibration capability in the training and validation sets.ConclusionsPreoperative CEA level, grading, and PNI were independent risk factor for LNM. Based on the present parameters, the constructed prediction model of LNM has potential application value.
Highlights
Colorectal cancer (CRC) is one of the most common malignancies with the second highest death rate in 2018 [1, 2]
Lymph node metastasis (LNM) was associated with the following clinicopathological parameters: tumor differentiation (P = 0.004), carcinoembryonic antigen (CEA) (P ≤0.01), pathological tumor (pT) stage (P = 0.004), peripheral nerve infiltration (PNI) (P ≤0.01), TABLE 1 | Clinicopathological characteristics of colon cancer patients in two data sets
The results of this study indicated that the LNM-associated nomogram has a favorable application prospect in patients with colon cancer
Summary
Colorectal cancer (CRC) is one of the most common malignancies with the second highest death rate in 2018 [1, 2]. Surgical treatment remains the primary treatment for CRC. The rate of lymph node metastasis (LNM) in early CRC is 6.9–19.6% [3,4,5,6]. Preoperative evaluation of LNM risk in colon cancer may help i) to provide information on an important prognostic factor [7, 8] and ii) to plan the most appropriate therapeutic and staging strategies, in the neoadjuvant setting [9]. Lymph node metastasis (LNM) is a well-established prognostic factor for colon cancer. Preoperative LNM evaluation is relevant for planning colon cancer treatment. The aim of this study was to construct and evaluate a nomogram for predicting LNM in primary colon cancer according to pathological features
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