Background Lymph node position is crucial to determining treatment for early gastric cancer (EGC). invasion (OR = 4.967, 95% CI, 2.996 to 8.235; P = 0.000). The discrimination 1369761-01-2 supplier of the prediction model was 0.786. Conclusions A nomogram for predicting lymph node metastasis in patients with early gastric cancer was successfully established, which was superior to the absolute endoscopic submucosal dissection (ESD) indication in terms of the clinical performance. Keywords: gastric cancer, lymph node metastasis, nomogram, endoscopic resection, decision analysis INTRODUCTION Early gastric cancer (EGC) has been increasing though overall incidence of gastric cancer declined around the 1369761-01-2 supplier world [1, 2]. According to Japanese Classification of Gastric Carcinoma (JCGC), EGC is usually defined as a lesion confined to the mucosa or the submucosa, regardless of the presence of lymph node metastases . The outcome of EGC patients with D2 lymphadenectomy is excellent, with 5-year survival more than 90% . As many as about 80% of patients exhibited no lymph node metastasis (LNM), many patients underwent excessive surgery and suffered from morbidity  therefore. Efforts have already been designed to improve the standard of living for EGC sufferers, such as for example endoscopic submucosal dissection (ESD) , sentinel lymph node biopsy (SLNB) , or pylorus-preserving gastrectomy . In East Asia, ESD continues to be accepted instead of surgery and attained a equivalent long-term result . Taking into consideration the threat of lymph nodal metastasis, just sufferers with differentiated mucosal adenocarcinoma, lack of lymphovascular invasion (LVI) and 20 mm or much less in size meet the criteria for 1369761-01-2 supplier ESD (total sign) . Provided the excessively tight indication, different strategies were suggested to broaden the ESD requirements for sufferers with negligible threat of Mouse monoclonal to EGF LNM [10, 11]. Even so, quantified prediction versions for LNM predicated on specific details stay absent still, which is vital for clinicians to consider treatment benefits and dangers. Nomogram is usually a graphic tool for individual probability of a clinical event based on a statistical predictive model. Increasing nomograms have been established for use in oncology. Two risk calculators developed from nomograms can efficiently identify the patients suitable for prostate cancer biopsy in a prospective multi-institutional study . Through a nomogram for 1369761-01-2 supplier predicting bone metastasis in breast malignancy, Delpech et al facilitated the selection of population at high risk for a virtual clinical trial . However, nomograms for LNM in EGC patients have been rarely reported. In this study, we aimed to develop a nomogram for predicting lymph node metastasis for patient with EGC. RESULTS Demographics of EGC patients Of the 952 patients, the average age was 55.3 11.3 years, and 631 cases (66.3%) were male. Tumor size was 2.75 1.66 cm. The number of lymph nodes harvested was 27.6 11.0, and 175 patients (18.4%) were found lymph node involvement. Tumors of differentiated type, signet ring cell carcinoma (SRC) and other undifferentiated type were 37.1% (353), 17.8% (169) and 45.2% (430), respectively. Mucosal tumor was detected in 440 patients (46.2%), and LVI in 92 (9.7%). Univariate and multivariate analysis on LNM risk factors In univariate analysis, sex (P < 0.001), tumor location (P = 0.003), depth of invasion (P < 0.001), tumor size (P < 0.001), histology type (P < 0.001) and LVI (P < 0.001) are closely related to LNM. Logistic regression modeling identified five factors to become connected with LNM considerably, including feminine sex (Unusual proportion [OR] = 1.961, 95% confidence index [CI], 1.334 to 2.883; P = 0.001), submucosa (OR = 2.875, 95% CI, 1.872 to 1369761-01-2 supplier 4.414; P = 0.000), tumor size > 3cm (OR =.