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

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.