title: A nomogram for predicting the likelihood of lymph node metastasis in early gastric patients.
abstract: BACKGROUND
  Early gastric cancer is defined as a lesion confined to the mucosa or submucosa, regardless of the size or lymph node metastasis. Treatment methods include endoscopic mucosal resection or endoscopic submucosal dissection, wedge resection, laparoscopically assisted gastrectomy and open gastrectomy. Lymph node metastasis is strong related with survival and recurrence. Therefore, the likelihood of lymph node metastasis is one of the most important factors when determining the most appropriate treatment.
  
  
  METHODS
  We retrospectively analyzed 597 patients who underwent D2 gastrectomy for early gastric cancer. The relationship between lymph node metastasis and clinicopathological features was analyzed. Using multivariate logistic regression analyses, we created a nomogram to predict the lymph node metastasis probability for early gastric cancer. Receiver operating characteristic analyses was performed to assess the predictive value of the model.
  
  
  RESULTS
  In the present study, 58 (9.7%) early gastric cancer patients were histologically shown to have lymph node metastasis. The multivariate logistic regression analysis demonstrated that the age at diagnosis, differentiation status, the presence of ulcers, lymphovascular invasion and depth of invasion were independent risk factors for lymph node metastasis in early gastric cancer. Additionally, the tumor macroscopic type, size and histology type significantly correlated with these important independent factors. We constructed a predictive nomogram with these factors for lymph node metastasis in early gastric cancer patients, and the discrimination was good with the AUC of 0.860 (95% CI: 0.809-0.912).
  
  
  CONCLUSIONS
  We developed an effective nomogram to predict the incidence of lymph node metastasis for early gastric cancer patients.
authors.affiliation: Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52 Fu Cheng Road, Hai Dian District, 100142, Beijing, China. zhengzhixue_bjch@163.com.
authors.forename: Zhixue
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52 Fu Cheng Road, Hai Dian District, 100142, Beijing, China. zhangyinan28@163.com.
authors.forename: Yinan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52 Fu Cheng Road, Hai Dian District, 100142, Beijing, China. zhanglianhai_bjch@163.com.
authors.forename: Lianhai
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52 Fu Cheng Road, Hai Dian District, 100142, Beijing, China. liziyu_bjch@163.com.
authors.forename: Ziyu
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52 Fu Cheng Road, Hai Dian District, 100142, Beijing, China. wuxiaojiang_bjch@163.com.
authors.forename: Xiaojiang
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China. liuyiqiang_bjch@163.com.
authors.forename: Yiqiang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52 Fu Cheng Road, Hai Dian District, 100142, Beijing, China. buzhaode@outlook.com.
authors.forename: Zhaode
authors.initials: Z
authors.lastname: Bu
authors.affiliation: Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52 Fu Cheng Road, Hai Dian District, 100142, Beijing, China. jijiafu_bjch@163.com.
authors.forename: Jiafu
authors.initials: J
authors.lastname: Ji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D049451:Nomograms; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery