淋巴结转移度对胃癌患者术后生存期的评估价值

Prognostic Value of Gastric Cancer Lymph Node Metastatic Ratio for Postoperative Survival of Patients with Gastric Cancer

目的探讨淋巴结转移度(LNR)对胃癌患者术后生存期的评估价值。方法回顾性分析2007年1月至2009年12月哈尔滨医科大学附属肿瘤医院收治的366例胃癌患者的临床病理资料和5年预后结果,分析LNR对患者术后5年生存期的评估价值。结果 Cox多因素分析显示,年龄、T分期、N分期、LNR是影响胃癌5年预后的危险因素(P<0.05)。Kaplan-Meier分析曲线显示,N分期、LNR均可将患者区分,且差异有统计学意义(P<0.05)。在淋巴结分期中,活检淋巴结总数增大后出现"分期漂移"。结论 LNR和N分期同样具有评估胃癌预后的能力,传统N分期由于"分期漂移"和其使用的限制条件等问题,有理由考虑使用LNR作为传统N分期的一种补充,尤其是对于早期胃癌等活检淋巴结数量淋巴结少的患者。

Objective To discuss the value of gastric cancer lymph node metastatic ratio（LNR） evaluation for postoperative survival of patients with gastric cancers. Methods Retrospective analysis on the clinic-pathological materials and the 5 years prognosis data of 366 gastric cancer patients from Harbin Medical University Affiliated Oncology Hospital during Jan. 2007 and Dec. 2009 was done, and the predictive value of LNR on 5-year survival was analyzed. Results Cox analysis showed that age, T stage, N stage, LNR are the independent hazard factors （P 〈 0.05 ）. The Keplan-Meier indicated that the ration stage and LNR could differentiate the patients with statistically significant difference （ P 〈 0.05 ）. In N staging, there was a ＂ stage drift＂ after the total number of biopsy lymph nodes increased. Conclusion LNR and N stage can both be used to predict the prognosis of the gastric cancer patients, however, the method of N stage has the restriction of ＂ stage drift＂ and usage limitations,it＇s reasonable to consider using LNR as a complement to the traditional N staging, especically for the patients with less lymph nodes in the early stage biopsy.