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Kshivets ASCO Chicago2020
1.
Precise Early Detection
of Gastric Cancer and Blood Cell Circuit Oleg Kshivets, MD, PhD Surgery Department, Roshal Hospital, Roshal, Moscow, Russia Objective: Significance of blood cell circuit in terms of early detection of gastric cancer (GC) was investigated. Methods: In trial (1975-2020) consecutive cases after surgery, monitored 136 GC patients (GCP) (m=90, f=46; distal gastrectomies=95, proximal gastrectomies=34, total gastrectomies=7) with pathologic stage IA (tumor size=1.81±0.70 cm; adenocarcinoma=136; T1N0M0=136; G1=67, G2=26, G3=43, 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 GC from HD (n=256) significantly depended on: leucocytes (abs, total), segmented neutrophils (%, abs, total), lymphocytes (%), monocytes (%, abs, total), stick neutrophils (%, abs, total), eosinophils (%, abs, total) (P=0.007-0.000). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships of early detection of GC and lymphocytes (rank=1), segmented neutrophils (rank=2), monocytes (3), stick neutrophils (4), leucocytes (5), eosinophils (6). Correct detection of early GCP was 100% by neural networks computing (error=0.000; area under ROC curve=1.0). Conclusion: Early detection of GC from HD significantly depended on blood cell circuit. e16512 Neural Networks: n=256; Baseline Error=0.000; Area under ROC Curve=1.000; Correct Classification Rate=100% Rank Sensitivity Lymphocytes 1 3581 Segmented Neutrophils 2 1475 Monocytes 3 817 Stick Neutrophils 4 737 Leucocytes 5 703 Eosinophils 6 685 Blood Factors Mean norm Mean Cancer t-value p Std.Dev. norm Std.Dev. Cancer Leucocytes 4.96500 5.86618-4.044770.000070 1.58240 1.93568 Stick Neutrophils 1.05833 1.61765-2.731940.006738 1.32396 1.86611 Segmented Neutrophils 55.8583364.64706-6.330510.00000010.6899011.42157 Eosinophils 3.22500 1.86029 3.751090.000218 3.66556 2.00803 Monocytes 3.11667 4.33824-3.983380.000089 2.38406 2.50398 Lymphocytes 36.8250027.50000 7.185430.00000010.3271410.39230 Eosinophils abs 0.16319 0.09863 2.893100.004146 0.23783 0.09930 Stick Neutrophils abs 0.05908 0.09768-2.909910.003936 0.08058 0.12406 Segmented Neutrophils abs 2.81104 3.81033-5.981630.000000 1.17819 1.45738 Lymphocytes abs 1.78054 1.60163 1.859940.064049 0.68395 0.83517 Monocytes abs 0.15323 0.25512-5.309020.000000 0.13311 0.16899 Eosinophils tot 0.78646 0.47996 2.778310.005872 1.17369 0.49549 Stick Neutrophils tot 0.28479 0.46715-2.877550.004349 0.40818 0.57865 Segmented Neutrophils tot 13.4859118.59339-5.443050.000000 6.00216 8.59387 Lymphocytes tot 8.52408 7.64274 1.836880.067397 3.38285 4.18631 Monocytes tot 0.73147 1.23458-5.145050.000001 0.65846 0.87446 Leucocytes tot 23.8068528.43292-3.638250.000332 8.3036611.53861 N=256 Discriminant Function Analysis Summary (ED_N_GC) No. of vars in model: 9; Grouping: NORM_CA (2 grps) Wilks' Lambda: .70485 approx. F (9,246)=11.446 p< .0000 Wilks' Lambda Partial Lambda F-remove (1,246) p-value Toler. 1-Toler. (R-Sqr.) Segmented Neutrophils 0.735002 0.958976 10.52371 0.001342 0.002534 0.997466 Eosinophils 0.728629 0.967364 8.29935 0.004316 0.027613 0.972387 Monocytes 0.719726 0.979330 5.19228 0.023545 0.031399 0.968601 Lymphocytes 0.744286 0.947015 13.76371 0.000256 0.002902 0.997098 Eosinophils tot 0.716097 0.984293 3.92569 0.048667 0.026257 0.973743 Segmented Neutrophils tot 0.727793 0.968475 8.00762 0.005043 0.000483 0.999517 Lymphocytes tot 0.730496 0.964891 8.95108 0.003055 0.001886 0.998114 Monocytes tot 0.724065 0.973461 6.70662 0.010178 0.026071 0.973929 Leucocytes tot 0.728309 0.967789 8.18765 0.004581 0.000272 0.999728 Effect NORM_CA - Test of all effects (ED_N_GC) Distribution : BINOMIAL, Link function: LOGIT Modeled probability that NORM_CA = norm Degr. of Freedo m Wald Stat. p Intercept 1 9.41076 0.002157 Leucocytes 1 4.34699 0.037074 Segmented Neutrophils 1 8.40957 0.003733 Eosinophils 1 11.43033 0.000723 Monocytes 1 4.60794 0.031824 Lymphocytes 1 11.77407 0.000601 Segmented Neutrophils abs 1 3.91261 0.047925 Segmented Neutrophils tot 1 11.23654 0.000802 Lymphocytes tot 1 8.03578 0.004586 Monocytes tot 1 6.50135 0.010779 Leucocytes tot 1 10.88927 0.000967
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