Abstract
BackgroundLymph node metastasis (LNM) plays a vital role in the determination of clinical outcomes in patients with gastric neuroendocrine tumor (G-NET). Preoperative identification of LNM is helpful for intraoperative lymphadenectomy. This study aims to investigate risk factors for LNM in patients with G-NET.MethodsWe performed a retrospective study involving 37 patients in non-LNM group and 82 patients in LNM group. Data of demographics, preoperative lab results, clinical–pathological results, surgical management, and postoperative situation were compared between groups. Significant parameters were subsequently entered into logistic regression for further analysis.ResultsPatients in LNM group exhibited older age (p = 0.011), lower preoperative albumin (ALB) (p = 0.003), higher carcinoembryonic antigen (CEA) (p = 0.020), higher International normalized ratio (p = 0.034), longer thrombin time (p = 0.018), different tumor location (p = 0.005), higher chromogranin A positive rate (p = 0.045), and higher Ki-67 expression level (p = 0.002). Logistic regression revealed ALB (p = 0.043), CEA (p = 0.032), tumor location (p = 0.013) and Ki-67 (p = 0.041) were independent risk factors for LNM in G-NET patients.ConclusionsALB, CEA, tumor location, and Ki-67 expression level correlate with the risk of LNM in patients with G-NET.
Highlights
Lymph node metastasis (LNM) plays a vital role in the determination of clinical outcomes in patients with gastric neuroendocrine tumor (G-NET)
Preoperative lab result consisted of white blood cell count, neutrophil cell count, lymphocyte count, monocyte count, hemoglobin, platelet, albumin (ALB), C-reactive protein (CRP) levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), Onodera prognostic nutrition index (OPNI), fecal occult blood test, carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), CA125, CA199, CA242, CA724, international normalized ratio (INR), activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT)
Similar recommendation was provided by the North American Neuroendocrine Tumor Society (NANETS) [10, 11]
Summary
Lymph node metastasis (LNM) plays a vital role in the determination of clinical outcomes in patients with gastric neuroendocrine tumor (G-NET). Preoperative identification of LNM is helpful for intraoperative lymphadenectomy. This study aims to investigate risk factors for LNM in patients with G-NET. Gastric neuroendocrine tumors (G-NET) formed by heterogeneous neoplasms arising from secretory cells of diffuse neuroendocrine system in stomach, one of the most common pathogenic site. Lymphadenectomy is required in patients with lymph node metastasis (LNM) for the prevention of recurrence and metastasis. The rate of LNM in G-NET is higher than that in gastric adenocarcinoma [6]. Preoperative risk evaluation, diagnosis, and management of LNM in G-NET have become challenging issues
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