Lymph node metastasis significantly affects the prognosis of early gastric cancer patients. EUS plays a crucial role in the preoperative assessment of early gastric cancer. This study evaluated the efficacy of EUS in identifying lymph node metastasis in early gastric cancer patients and developed a risk score model to aid in choosing the best treatment options. We retrospectively analyzed the effectiveness of EUS for detecting lymph node metastasis in early gastric cancer patients. A risk score model for predicting lymph node metastasis preoperatively was created using independent risk factors identified through binary logistic regression analysis and subsequently validated. Receiver operating characteristic curves were generated for both the development and validation cohorts. The overall accuracy of EUS in identifying lymph node metastasis was 85.3%, although its sensitivity (29.2%) and positive predictive value (38.7%) were relatively low. Patients were categorized based on preoperative risk factors for lymph node metastasis, including tumor size of ≥20 mm, lymph nodes of ≥10 mm, body mass index of ≥24 kg/m, and lymph node metastasis on CT scans. A 7-point risk score model was developed to assess the likelihood of lymph node metastasis. The areas under the receiver operating characteristic curve for the development and validation sets were 0.842 and 0.837, respectively, with sensitivities of 64% and 79%, respectively. We developed a practical risk score model based on preoperative factors to help EUS predict lymph node metastasis in early gastric cancer patients, guiding the selection of optimal treatment approaches for these patients.

中文翻译：

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基于EUS的风险评分模型的建立与验证：评估早期胃癌淋巴结转移


淋巴结转移显着影响早期胃癌患者的预后。 EUS在早期胃癌的术前评估中起着至关重要的作用。本研究评估了 EUS 在识别早期胃癌患者淋巴结转移方面的功效，并开发了风险评分模型以帮助选择最佳治疗方案。我们回顾性分析了EUS检测早期胃癌患者淋巴结转移的有效性。使用通过二元逻辑回归分析确定的独立风险因素创建了术前预测淋巴结转移的风险评分模型，并随后进行了验证。为开发组和验证组生成了接受者操作特征曲线。 EUS识别淋巴结转移的总体准确率为85.3%，但其敏感性（29.2%）和阳性预测值（38.7%）相对较低。根据术前淋巴结转移的危险因素对患者进行分类，包括肿瘤大小≥20 mm、淋巴结≥10 mm、体重指数≥24 kg/m以及CT扫描淋巴结转移。开发了 7 分风险评分模型来评估淋巴结转移的可能性。开发集和验证集的受试者工作特征曲线下面积分别为 0.842 和 0.837，灵敏度分别为 64% 和 79%。我们基于术前因素开发了实用的风险评分模型，帮助 EUS 预测早期胃癌患者的淋巴结转移，指导这些患者选择最佳治疗方案。