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Analysis of influencing factors of nerve invasion in locally advanced gastric cancer

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Abstract

Objectives

Accurate preoperative diagnosis of locally advanced gastric cancer (GC) with nerve invasion is very important for guiding the clinical formulation of a reasonable treatment plan, improving treatment efficacy, and improving prognosis. The present study sought to analyze and evaluate the clinicopathological features of locally advanced GC, and to explore the risk factors associated with the state of nerve invasion.

Methods

The clinicopathological data of 296 patients with locally advanced GC were retrospectively analyzed in our hospital from July 2011 to December 2020 who underwent radical gastrectomy. PNI is defined as a tumor close to the nerve and involving at least 33% of its circumference or tumor cells within any of the 3 layers of the nerve sheath. The patient's age, gender, tumor location, T stage, N stage, TNM stage, degree of differentiation, Lauren classification, microvascular invasion, as well as TAP, AFP, CEA, CA125, CA199, CA724, CA153, tumor thickness, longest diameter, and plain CT value, arterial phase CT value, venous phase CT value, arterial phase enhancement rate, venous phase enhancement rate were assessed.

Results

A total of 296 patients with locally advanced GC were included, and 226 (76.35%) were positive for nerve invasion. Univariate analysis showed that tumor T stage, N stage, TNM stage, Lauren classification, tumor thickness, and longest diameter were related to the state of nerve invasion (P < 0.05). Multivariate analysis showed that tumor TNM stage was an independent risk factor for nerve invasion (OR 0.393, 95%CI 0.165–0.939, P = 0.036).

Conclusions

Tumor TNM stage is an independent risk factor for nerve invasion (+) in patients with locally advanced GC. Patients at high risk of nerve invasion should be followed closely and, if necessary, performed pathological examinations.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

GC:

Gastric cancer

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Funding

This study was supported by the Outstanding Youth Project in Henan Province for Young and Middle-aged Health and Health Technology Innovation, Grant No. YXKC2020053.

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Authors and Affiliations

  1. Department of Ultrasonography, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China

    Xiu-chun Ren

  2. Department of Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, 450052, China

    Pan Liang

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  1. Xiu-chun Ren
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  2. Pan Liang
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Contributions

RX is the primary author. Liang Pan critically reviewed the paper and revised it. LP and RX performed the database search and literary review. All authors read and approved the final manuscript.

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Correspondence to Pan Liang.

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Ren, Xc., Liang, P. Analysis of influencing factors of nerve invasion in locally advanced gastric cancer. Abdom Radiol 48, 3005–3011 (2023). https://doi.org/10.1007/s00261-023-03970-6

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  • DOI: https://doi.org/10.1007/s00261-023-03970-6

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