胃癌根治术后淋巴结转移率与患者预后的关系

Prognostic Significance of Metastatic Lymph Node Ratio in Gastric Cancer Patients

目的探讨淋巴结转移率对胃癌患者预后预测的意义。方法回顾性分析我院238例胃癌根治术患者的术后病理资料,分析胃癌患者预后和UICC/AJCC N分期及淋巴结转移率的关系。结果患者术后5年累计生存率为42.0%,UICC/AJCC N分期和淋巴结转移率均是胃癌患者的预后预测因素。根据UICC/AJCC N分期系统,获得淋巴结总数大于15枚和少于15枚的同一N分期患者术后5年生存率存在显著差异。但根据淋巴结转移率分期系统,淋巴结总数大于15枚和少于15枚的同一淋巴结转移率分期患者预后无显著差异。结论淋巴结转移率是胃癌患者的简单、可靠的预后预测因素,可以防止获得淋巴结总数不足导致的N分期降低。

Objective To analyze the prognostic significance of the staging system based on the ratio of metastatic lymph nodes（MLR） in patients with gastric cancer.Methods We retrospectively analyzed the clinical data of 238 consecutive patients diagnosed with gastric cancer who underwent curative gastrectomy at our hospital.The lymph node status was classified according to two systems： the International Union Against Cancer/American Joint Committee on Cancer（UICC/AJCC） system and an MLR-based system（MLR0： 0,MLR1： 0.01~0.19,MLR2：≥0.2）.Overall survival was examined according to N status and N ratio.Results Overall survival stratified by N status was significantly different in patients with 15 nodes examined compared with those with ≥15 nodes examined.When we stratified by N ratio intervals,there was no significantly difference in overall survival in patients with 15 versus ≥15 nodes examined.On univariate analysis,N ratio and N status was retained as an independent prognostic factor.Conclusion The MLR staging system is a simple and reliable tool to stratify patients with gastric cancer and has a higher prognostic power.