A Risk-prediction Model Based on Lymph-node @entity3 for Incorporation Into a Treatment Algorithm for Signet Ring Cell-type Intramucosal XXXX .

@entity1 @entity455 @entity5 @entity262 @entity2580 @entity3 @entity356
OBJECTIVE: The aim of the study was to develop a reliable and easy-to-use @entity262 ( @entity262 ) to predict lymph-node @entity3 (LNM) and determine the feasibility of endoscopic submucosal dissection for mucosa-confined @entity2580 ( @entity2580 ). BACKGROUND: Fewer LNM and better survival rates have been reported for early gastric @entity2580 compared with other undifferentiated early @entity356 (EGCs). METHODS: Data from 1544 @entity1 with mucosa-confined @entity2580 were reviewed. Stepwise logistic regression analysis determined the independent predictors of LNM. Risk scores were based on the final predictive factors for LNM, and performance was internally validated using a split-sample approach. External validation was also performed in an independent dataset (n = 208) to assess the discriminatory power of the @entity262 . RESULTS: The overall LNM incidence was 3.8% (57/1544). Three risk factors ( @entity5 size >= 1.7cm, @entity5 of elevated type, and @entity455 ) were significantly associated with LNM. These factors were incorporated into the @entity262 , and were assigned scores ranging from 0 to 4. The area under the receiver-operating characteristic curve for predicting LNM after internal and external validation was 0.68 (95% confidence interval, 0.0793-0.2865) and 0.686 (95% confidence interval, 0.618-0.748), respectively. A score of 2 points was the optimal cut-off value for LNM prediction, and the overall diagnostic accuracy was 96%. LNM were found in 2.9% and 23.8% of the low and high-risk groups of the @entity262 , respectively. CONCLUSIONS: A @entity262 may help to predict LNM and evaluate endoscopic submucosal dissection feasibility in @entity1 with intramucosal SRC.
