摘要
Abstract
Purpose To investigate the independent risk factors for early papillary gastric adenocarcinoma(EP-GA)and construct a diagnostic nomogram.Methods A retrospective analysis was performed on the clinicopathologi-cal characteristics of 325 cases of early differentiated gastric adenocarcinoma.Taking EPGA as the case group and early well-moderately differentiated tubular gastric adenocarcinoma(ETGA)as the control group,the independent risk fac-tors for the occurrence of EPGA were identified through univariate and multivariate analyses,and a nomogram was con-structed.The diagnostic performance of the nomogram was evaluated using the receiver operating characteristic(ROC)curves,Hosmer-Lemeshow goodness-of-fit tests,and calibration curves.Results Among the 325 cases of early differ-entiated gastric adenocarcinoma,there were 121 cases of EPGA and 204 cases of ETGA.Univariate analysis showed that elevated appearance(56.3％),ulcer formation(11.5％),tumor maximum diameter of 2.15(1.60,3.00)cm,moderately-differentiated(55.2％),submucosal invasion(21.9％),lymphovascular invasion(10.4％),high ex-pression of MUC5AC(75.0％),microsatellite instability-high(15.6％),and wild-type expression of p53(59.4％)were significantly associated with an increased risk of EPGA.Multivariate analysis revealed that gross appearance,ul-cer formation,tumor maximum diameter,and the expression of MUC5AC was independent risk factors for EPGA.A di-agnostic nomogram was constructed,and the area under the ROC curve(AUC)was calculated.In the training and val-idation cohorts,the AUC values were 0.847(95％CI=0.799-0.896)and 0.830(95％CI=0.733-0.927),re-spectively.The Hosmer-Lemeshow goodness-of-fit tests showed that x2=13.498,P=0.096,and x2=7.138,P=0.415,respectively.Conclusion The nomogram,based on independent risk factors,exhibits good accuracy for diag-nosing EPGA and can help pathologists in achieving rapid and precise EPGA diagnosis.关键词
胃肿瘤/早期乳头状胃腺癌/临床病理特征/危险因素/列线图/MUC5AC/微卫星不稳定性Key words
gastric neoplasms/early papillary gastric adenocarcinoma/clinicopathological characteristics/risk fac-tors/nomogram/MUC5AC/microsatellite instability分类
医药卫生
