淋巴结转移率对各pT分期胃癌患者生存状况的评估效果

Prognostic value of living conditions in gastric cancer patients by pT stage

目的探究淋巴结转移率(metastatic lymph node ratio,MLR)对各p T分期胃癌患者生存状况的评估效果。方法回顾性分析2008年1月至2010年1月于本院接受手术治疗的1070例胃癌患者的临床资料,比较UICC/AJCC p N分期和MLR对胃癌患者预后的评价价值,同时分析MLR对各p T分期胃癌患者预后的评价价值。结果单因素分析显示,年龄、肿瘤大小、部位及其分化程度均为胃癌患者的预后影响因素。Borrmann分型、p T分期、MLR分期和p N分期均与患者的预后有一定相关性,其中MLR与患者预后密切相关,MLR各期患者5年生存率比较差异具有显著性,MLR分期越高,患者预后越差(P<0.05)。多因素分析显示,肿瘤分化程度、MLR、手术根治程度、p T分期均为影响胃癌患者预后的独立因素。p N各期患者的5年生存率比较具有差异性,p N分期越高,患者预后越差(P<0.05)。结论 MLR是影响胃癌患者预后的独立因素,能够准确评估胃癌患者的预后,且准确性高于p N分期,尤其对于p T2和p T3期胃癌患者的预后有良好的评估价值。

Objective To explore the rate of metastatic lymph node ratio（MLR） provision of p T stage gastric cancer patient survival condition assessment of the effect. Method 1070 patients with gastric cancer were treated in our hospital from January 2008 to January 2010. Compared UICC/AJCC p N stage and MLR value in evaluating the prognosis of patients with gastric cancer, at the same time, analyzed MLR value in evaluating the p T stage the prognosis of patients with gastric cancer. Result Single factor analysis showed that, age, tumor size, tumor location, degree of differentiation were all factors affecting the prognosis of patients with gastric cancer. Borrmann type, p T stage, MLR staging and p N stage had certain correlation with the prognosis of patients, the MLR was closely related to the prognosis of patients, MLR0, MLR1, MLR2, MLR3 period of 5 years survival rate compared with significant difference（P〈0.05）, the higher the MLR staging in patients with worse prognosis. Multiple factors analysis showed that degree of differentiation, degree of MLR, operation cure, p T stage were independent factors affecting the prognosis of patients with gastric cancer. MLR periods the 5-year survival rate of patients with a difference, the higher the MLR in installment, the worse prognosis in patients with statistical significance（P〈0.05）. PN periods the 5-year survival rate of patients with a difference, the higher the p N in installment, the worse prognosis in patients with statistical significance（P〈0.05）. Conclusion MLR is an independent prognostic factor in patients with gastric cancer, can accurately predict the prognosis of patients with gastric cancer, and accuracy is higher than the p N staging system, especially for p T2 and p T3 prognosis of gastric cancer patients have a good assessment of the value.