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1.
Precise Early Detection
of Esophageal Cancer and Blood Cell Circuit P25 Oleg Kshivets, MD, PhD Surgery Department, Roshal Hospital, Roshal, Moscow, Russia Objective: Significance of blood cell circuit in terms of early detection of esophageal cancer (EC) was investigated. Methods: In trial (1975-2018) consecutive cases after surgery, monitored 82 EC patients (ECP) (m=60, f=22; esophagectomies Lewis=70, esophagectomies Garlock=12) with pathologic stage IA (tumor size=1.46±0.48 cm; squamous=48, adenocarcinoma=34; T1N0M0=82; G1=46, G2=22, G3=14, 5-year survival=100%) and 120 healthy donors (HD) (m=69, f=51) were reviewed. 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 early detection of EC from HD (n=202) significantly depended on: leucocytes (abs, total), segmented neutrophils (%, abs, total), lymphocytes (%, abs), monocytes (%, abs, total), stick neutrophils (%, abs, total), eosinophils (%, abs, total) (P=0.048-0.000). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships of early detection of EC and lymphocytes (rank=1), segmented neutrophils (rank=2), monocytes (3), leucocytes (4), eosinophils (5), stick neutrophils (6). Correct detection of early ECP was 100% by neural networks computing (error=0.000; area under ROC curve=1.0). Conclusion: Early detection of EC from HD significantly depended on blood cell circuit. Neural Networks: n=202; Baseline Error=0.000; Area under ROC Curve=1.000; Correct Classification Rate=100% Rank Sensitivity Lymphocytes Segmented Neutrophils Monocyte Leucocytes Eosinophils Stick Neutrophils 1 2 3 4 5 8 1270 569 387 364 263 247 Blood Factors Mean Norm Mean EC t-value p Std.Dev. Norm Std.Dev. EC Leucocytes 4.96500 6.01463 -4.28094 0.000029 1.58240 1.88471 Stick Neutrophils 1.05833 1.50000 -2.12950 0.034436 1.32396 1.61207 Segmented Neutrophils 55.85833 65.69512 -6.00144 0.000000 10.68990 12.46000 Eosinophils 3.22500 1.81707 3.23342 0.001431 3.66556 1.75068 Monocytes 3.11667 4.86585 -4.86415 0.000002 2.38406 2.68403 Lymphocytes 36.82500 25.93902 7.11851 0.000000 10.32714 11.16249 Eosinophils (abs) 0.16319 0.10306 2.18615 0.029965 0.23783 0.08879 Stick Neutrophils (abs) 0.05908 0.09315 -2.58157 0.010550 0.08058 0.10682 Segmented Neutrophils (abs) 2.81104 3.97573 -6.07321 0.000000 1.17819 1.54411 Lymphocytes (abs) 1.78054 1.53635 2.28731 0.023224 0.68395 0.82678 Monocytes (abs) 0.15323 0.29521 -6.23906 0.000000 0.13311 0.19041 Eosinophils (tot) 0.78646 0.51523 1.98565 0.048438 1.17369 0.46953 Stick Neutrophils (tot) 0.28479 0.48383 -2.90713 0.004059 0.40818 0.56480 Segmented Neutrophils (tot) 13.48591 20.04112 -6.25576 0.000000 6.00216 8.89620 Monocytes (tot) 0.73147 1.46806 -6.21523 0.000000 0.65846 1.02587 Leucocytes (tot) 23.80685 30.19826 -4.64835 0.000006 8.30366 11.22937 N=202 Model: Logistic regression (logit) N of 0's: 120 1's: 82 Dep. var: NORM--CA Loss: Max likelihood Final loss: 85.816840002 Chi2( 17)=101.21 p=.00000 Modeled probability that P = norm Const.B0 L ST S E M LYM Eabs STabs Sabs LYMabs Mabs Etot STtot Stot LYMtot Mtot Ltot Estimate 319.565 45.26 -2.6078 -3.1686 -3.0135 -2.8227 -3.375 -70.14 -67.19 -46.40 -40.72 -43.43 20 19 17 16 16 -16.6368 Odds ratio (unit ch) 0.0737 0.04206 0.0491 0.05944 0.034 0.000 0.000 0.000 0.000 0.000 581987200 127613700 21046710 9372915 11601350 0.0000 Odds ratio (range) 0.0000 0.00000 0.0000 0.00000 0.000 0.000 0.000 0.000 0.000 0.000 0.0000 Bootstrap Simulation Significant Factors (Number of Samples=3333) Rank Kendall’Tau-A P< Lymphocytes 1 0.272 0.001 Monocytes tot 2 -0.234 0.001 Monocytes abs 3 -0.230 0.001 Segmented Neutrophils 4 -0.225 0.001 Segmented Neutrophils tot 5 -0.222 0.001 Segmented Neutrophils abs 6 -0.219 0.001 Monocytes 7 -0.195 0.001 Leucocytes tot 8 -0.159 0.01 Leucocytes 9 -0.155 0.01 Eosinophils 10 0.143 0.01 Lymphocytes abs 11 0.112 0.05
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