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