手术前无创工具精确预测食管胃 junction 腺癌（EJA）新生淋巴结转移（PLNM）状态的研究较少。因此，作者旨在构建一个预测EJA经过治愈性切除后PLNM的评分表。本研究纳入了638名接受治愈性手术切除的EJA患者，并将其随机分为训练和验证组（7:3）。在评分表构建中，筛选了涉及21个手术前临床实验室血液营养相关指标、计算机断层扫描（CT）报告的肿瘤大小、CT报告的PLNM、性别、年龄和体质指数的26个候选参数。在训练组中，Lasso回归在PLNM预测小组图表中包括了九个营养相关的血液指标。预测EJA PLNM的图表的受试操作特征曲线下面积为0.741（95％置信区间[CI]，0.697-0.781），优于CT报告的PLNM的结果（0.635; 95％CI 0.588-0.680; p <0.0001）。将评分表应用于验证队仍然具有良好的区分度（0.725 [95％CI 0.658-0.785] vs 0.634 [95％CI 0.563-0.700]; p = 0.0042）。两组中都观察到了良好的校准和净益。本研究提供了一个包含术前营养相关指标和CT成像特征的评分表，可作为一个方便的工具，有助于对治愈性切除EJA患者进行术前的个体化PLNM预测。©2023年外科肿瘤学会。

Preoperative noninvasive tools to predict pretreatment lymph node metastasis (PLNM) status accurately for esophagogastric junction adenocarcinoma (EJA) are few. Thus, the authors aimed to construct a nomogram for predicting PLNM in curatively resected EJA.This study enrolled 638 EJA patients who received curative surgery resection and divided them randomly (7:3) into training and validation groups. For nomogram construction, 26 candidate parameters involving 21 preoperative clinical laboratory blood nutrition-related indicators, computed tomography (CT)-reported tumor size, CT-reported PLNM, gender, age, and body mass index were screened.In the training group, Lasso regression included nine nutrition-related blood indicators in the PLNM-prediction nomogram. The PLNM prediction nomogram yielded an area under the receiver operating characteristic (ROC) curve of 0.741 (95 % confidence interval [CI], 0.697-0.781), which was better than that of the CT-reported PLNM (0.635; 95% CI 0.588-0.680; p < 0.0001). Application of the nomogram in the validation cohort still gave good discrimination (0.725 [95% CI 0.658-0.785] vs 0.634 [95% CI 0.563-0.700]; p = 0.0042). Good calibration and a net benefit were observed in both groups.This study presented a nomogram incorporating preoperative nutrition-related blood indicators and CT imaging features that might be used as a convenient tool to facilitate the preoperative individualized prediction of PLNM for patients with curatively resected EJA.© 2023. Society of Surgical Oncology.