The correlation between preoperative total lesion glycolysis and lymphovascular invasion based on

Background: Lymphovascular invasion (LVI) is a critical factor in the lymphatic spread of tumor cells, and is closely associated with local recurrence and distant metastasis in gastric cancer. The study aimed to evaluate the correlation and predictive value of preoperative total lesion glycolysis (TLG) in patients with primary gastric cancer as measured by a combination of Methods: A retrospective analysis of the demographic and Results: Among the 177 patients, 71 (40.1%) were LVI+, and 106 (59.9%) were LVI-. Significant differences were observed between the two groups in terms of the primary lesion size, LNM status, age, SUVmax, SUVmean, MTV, and TLG (all P<0.05 or P<0.001). A per standard deviation (SD) increase in TLG was associated with a 59.1% increased risk of LVI [odds ratio (OR) =1.591; 95% confidence interval (CI): 1.142-2.216; P=0.006]. After adjusting for confounders, TLG remained significantly associated with an increased risk of LVI (OR per SD: 1.428; 95% CI: 1.018-2.002; P=0.039). Treating TLG as a categorical variable produced consistent results (P for trend =0.014). In the clinical lymph node metastasis positive (cLNM+) subgroup, a TLG value ≥53.3 predicted LVI with a sensitivity of 81.4% (35/43), a specificity of 37.8% (14/37), and an accuracy of 61.3% (49/80). In the clinical lymph node metastasis negative (cLNM-) subgroup, a TLG value ≥41.9 predicted LVI with a sensitivity of 82.1% (23/28), a specificity of 53.6% (37/69), and an accuracy of 61.9% (60/97). Conclusions: Preoperative TLG exhibits a positive linear correlation with the risk of LVI in primary gastric cancer. TLG shows high sensitivity for predicting LVI, making it a valuable imaging biomarker for assessing LVI risk in gastric cancer, especially in cLNM- but LVI+ patients.