不同淋巴结分期方法预测胃癌预后的能力

Ability of different lymph node staging methods in predicting the prognosis of gastric cancer

目的:比较第8版美国肿瘤联合会(American Joint Committee on Cancer,AJCC)/国际抗癌联盟(Union for International Cancer Control,UICC)胃癌淋巴结分期(N分期)、淋巴结转移率(metastatic ly mph node ratio,r N)分期和阳性淋巴结对数比(log odds of positive ly mph nodes,LODDS)3种淋巴结分期方法对于接受胃癌根治术后患者预后的预测性能。方法:收集117例2009年1月至2011年12月在安徽医科大学第三附属医院胃肠外科接受胃癌根治术患者的病理及随访数据,并进行受试者工作特征(receiver operating characteristic,ROC)曲线分析。评估不同淋巴结分期方法对于预后的预测性能。结果:总体样本中3种分期方法均有预测性能,而LODDS分期方法的预测性能高于N分期及r N分期;在总体转移淋巴结数为0的样本中,仅LODDS分期有预测性能。而将三者作为连续性变量分析时,预测能力上升。结论:LODDS的预测性能优于N分期及r N分期;当总体转移淋巴结数为0时,仅LODDS分期有预测性能。将淋巴结情况作为连续性变量能更好地评估预后。

Objective： To compare the ability in predicting the prognosis of gastric cancer among the N staging of gastric cancer of the Eighth American Joint Committee on Cancer （AJCC）/Union for International Cancer Control （UICC）, the metastatic lymph node ratio （rN） and the log odds of positive lymph nodes （LODDS）. Methods： The pathological and follow-up data of 117 gastric cancer patients who received radical operation in Gastrointestinal Surgery of Third Affiliated Hospital of Medical University of Anhui were collected and analyzed with receiver operating characteristic （ROC） curves. The ability of predicting the prognosis of gastric cancer was compared. Results： All the three staging systems have ability in predicting the prognosis of gastric cancer in the overall sample, while the LODDS is better than the N and the rN. Only the LODDS had prognostic value in the sample without lymph node metastasis. And the ability will rise when the date is seen as continuity variables. Conclusion： The ability of LODDS is better than the N and the rN. Only the LODDS had prognostic value in the sample without lymph node metastasis. And the ability will rise when the date is seen as continuity variables.