Abstract:
Objective To establish a model of conventional white light endoscopy (C-WLE) combined with magnifying endoscopy with narrow-band imaging (ME-NBI) for accurately determining the infiltration depth of early gastric cancer (EGC).
Methods The data of 241 patients with EGC, who underwent endoscopic submucosal dissection (ESD) or surgery in The Fourth Hospital of Hebei Medical University between January 2018 and October 2020, were retrospectively analyzed. The risk factors of deep submucosal infiltration of EGC were analyzed by chi-square test. A Logistic regression model was used to analyze the independent risk factors of endoscopic manifestations of EGC submucosal deep invasion, and to construct a model for predicting the EGC invasion depth.
Results Mucosal fold change, bleeding, ulceration, marginal elevation, non-vascular regions, dilated blood vessels, and absence of microvascular architecture and surface structure were risk factors for EGC submucosal deep infiltration. Ulceration (odds ratio OR=5.696, 95%confidence interval CI:1.656–19.590, P=0.006), marginal elevation (OR=5.363,95%CI: 1.469–19.57, P=0.011), non-vascular regions (OR=8.990, 95%CI: 2.522–32.042, P=0.001), and dilated blood vessels (OR=8.435,95%CI: 3.323–21.408, P<0.001) were independent risk factors for EGC submucosal deep infiltration, and these were assigned 4, 4, 5, and 5 points, respectively. Using this data, a prediction model of EGC infiltration depth was constructed, with an area under the curve (AUC) of 0.802. The model had a cut-off score of 8 points, sensitivity of 71.4%, specificity of 85.6%, and diagnostic accuracy of 82.5%.
Conclusions This noveldiagnostic model constructed based on the independent risk factors of C-WLE combined with ME-NBI helps in diagnosing EGC submucosal deep infiltration and aids in accurately determining the depth of EGC infiltration preoperatively.
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