e16024 Background: Significance of blood cell circuit in terms of detection of gastric cancer (GC) patients (GCP) with lymph node metastases was investigated. Methods: We analyzed data of 793 consecutive GCP (age = 57±9.4 years; tumor size = 5.4±3.1 cm) radically operated (R0) and monitored in 1975-2021 (m = 555, f = 238; distal gastrectomies = 460, proximal gastrectomies = 163, total gastrectomies = 170, combined gastrectomies with resection of pancreas, liver, diaphragm, colon transversum, esophagus, duodenum, splenectomy, small intestine, kidney, adrenal gland = 244; D2-lymphadenectomy = 513, D3-4 = 280; T1 = 235, T2 = 220, T3 = 182, T4 = 156; N0 = 433, N1 = 109, N2 = 251; G1 = 222, G2 = 162, G3 = 409; early GC = 162, invasive = 631; only surgery = 621, adjuvant chemoimmunotherapy-AT = 172 (5-FU+thymalin/taktivin). Variables selected for study were input levels of blood cell circuit, sex, age, TNMG. Differences between groups were evaluated using discriminant analysis, clustering, nonlinear estimation, structural equation modeling, Monte Carlo, bootstrap simulation and neural networks computing. Results: It was revealed that separation of GCP with lymph node metastases (n = 360) from GCP without metastases (n = 433) significantly depended on: eosinophils (%, abs, total), thrombocytes (abs, total), ESS, Hb, erythrocytes (abs), residual nitrogen, protein, cell ratio factors (CRF) (ratio between cancer cells- CC and blood cells subpopulations), T, G, tumor size, histology, tumor growth, blood group, procedures type (P = 0.043-0.000). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships of lymph node metastases and CRF: thrombocytes/CC (rank = 1), healthy cells/CC (2), erythrocytes/CC (3), monocytes/CC (4), segmented neutrophils/CC (5), lymphocytes/CC (6), leucocytes/CC (7), eosinophils/CC (8), stick neutrophils/CC (9). Correct classification N0—N12 was 99.9% by neural networks computing (area under ROC curve = 1.0; error = 0.0). Conclusions: Lymph node metastases of gastric cancer significantly depended on blood cell circuit.
Risk Factors for Lymph Node Metastases and their Prognostic Significance in Early Gastric Cancer (EGC) for the Italian Research Group for Gastric Cancer (IRGGC)
