Abstract
Objective
The consistency between clinical staging and pathological staging of lymph nodes (LNs) in gastric cancer (GC) remains consistently low, and there is currently no standardized imaging criterion available for diagnosing lymph node metastasis (LNM). To clarify the differences in LNs among different groups, regions, and stages, we conducted a study on the LNs of patients with GC, utilizing imaging and histopathology as the fundamental basis.
Methods
This study retrospectively analyzed the clinical data of 100 patients diagnosed with GC who underwent surgical treatment at Zhongnan Hospital of Wuhan University between January 2022 and May 2023. We collected the basic characteristics of patients, as well as pathological and radiological data of LNs, and compared these data among different groups, regions, and stages.
Results
In terms of pathology, a total of 3566 LNs were collected, with a median of 35 (17–72). In terms of imaging, a total of 2233 LNs were collected, with a median of 22 (3–47). Differences were observed in the long-axis diameter (LAD), short-axis diameter (SAD), ratios of long to short axis RLSA), and product of long and short axis (PLSA) between negative LNs and positive LNs. However, only within group 3 did the RLSA show statistical difference after conducting grouping analysis. The areas under the curve (AUC) for the LAD, SAD, PLSA, and their combination index (CI) in diagnosing LNM were 0.817, 0.817, 0.828, and 0.827 respectively. Diverse groups, regions, and stages exerted a more pronounced influence on LN groups 1–6, while exhibiting a comparatively lesser impact on LN groups 7–16.
Conclusion
The LAD, SAD, and PLSA exhibited significant diagnostic value for LNM and could be employed as diagnostic criteria; however, the RLSA demonstrated limited diagnostic value. The formulation of diagnostic criteria should consider the impact of groups, regions, and stages in order to enhance the sensitivity and specificity.