title: Prediction of lymph node metastasis in patients with submucosa-invading early gastric cancer.
abstract: OBJECTIVE
  Early gastric cancer (EGC), with wall invasion limited to the submucosa, has approximately 15 to 20% chance of lymph node metastasis. The purpose of this study is to clarify the parameters which affect lymph node metastasis and survey whether lymph node metastasis can be predicted preoperatively.
  
  
  METHODS
  We retrospectively analyzed 145 consecutive patients with EGC using multivariate analysis and developed a formula which predicts lymph node metastasis by linear discriminant analysis. In addition, we prospectively validated this formula in another subset of 106 consecutive patients with EGC and compared the predicted with the actual pathological lymph node metastasis.
  
  
  RESULTS
  Multivariate analyses revealed that independent factors, which affect lymph node metastasis for EGC, were lymphatic system invasion (p=0.00002, odds ratio 3.11) and venous system invasion (p=0.039, odds ratio 2.44). In addition, we developed the lymph node metastasis-predicting formula using these two factors by linear discriminant analysis. The formula is as follows: Y=0.12 × (venous system invasion: 0, 1, 2 or 3) + 0.19 × (lymphatic system invasion: 0, 1, 2, or 3) - 0.14. If Y>0, we judge that a patient with gastric cancer is susceptible lymph node metastasis. The result of this prospective study showed that the sensitivity and specificity rates were 70% and 61.6%, respectively.
  
  
  CONCLUSIONS
  We developed a formula which can predict lymph node metastasis using linear discriminant analysis. This formula seems useful in predicting for lymph node metastasis in patients with EGC.
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan atsuoshida@ybb.ne.jp.
authors: Atsuo
authors: A
authors: Shida
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Shuichi
authors: S
authors: Fujioka
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Masahiko
authors: M
authors: Kawamura
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Naoto
authors: N
authors: Takahashi
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Yoshio
authors: Y
authors: Ishibashi
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Koji
authors: K
authors: Nakada
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Norio
authors: N
authors: Mitsumori
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Nobuo
authors: N
authors: Omura
authors: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Katsuhiko
authors: K
authors: Yanaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*
keywords: Gastric cancer; linear discriminant analysis; prediction of lymph node metastasis