N 比值是否会影响胃癌 D1 和 D2 淋巴结清扫术的生存？
Does N ratio affect survival in D1 and D2 lymph node dissection for gastric cancer?
机构信息
Department of 6th General Surgery, Numune Teaching and Research Hospital, 06100 Sihhiye, Ankara, Turkey.
出版信息
World J Gastroenterol. 2011 Sep 21;17(35):4007-12. doi: 10.3748/wjg.v17.i35.4007.
AIM
To identify whether there could have been changes in survival if lymph node ratio (N ratio) had been used.
METHODS
We assessed 334 gastric adenocarcinoma cases retrospectively between 2001 and 2009. Two hundred and sixteen patients out of 334 were included in the study. Patients were grouped according to disection1 (D1) or dissection 2 (D2) dissection. We compared the estimated survival and actual survival determined by Pathologic nodes (pN) class and N ratio, and SPSS 15.0 software was used for statistical analysis.
RESULTS
Ninety-six (44.4%) patients underwent D1 dissection and 120 (55.6%) had D2 dissection. When groups were evaluated, 23 (24.0%) patients in D1 and 21 (17.5%) in D2 had stage migration (P = 0.001). When both D1 and D2 groups were evaluated for number of pathological lymph nodes, despite the fact that there was no difference in N ratio between D1 and D2 groups, a statistically significant difference was found between them with regard to pN1 and pN2 groups (P = 0.047, P = 0.044 respectively). In D1, pN0 had the longest survival while pN3 had the shortest. In D2, pN0 had the longest survival whereas pN3 had the shortest survival.
CONCLUSION
N ratio is an accurate staging system for defining prognosis and treatment plan, thus decreasing methodological errors in gastric cancer staging.
目的
确定如果使用淋巴结比率（N 比），生存情况是否会发生变化。
方法
我们回顾性评估了 2001 年至 2009 年间的 334 例胃腺癌病例。334 例患者中有 216 例纳入研究。根据解剖 1（D1）或解剖 2（D2）分组。我们比较了通过病理淋巴结（pN）分类和 N 比确定的估计生存率和实际生存率，并使用 SPSS 15.0 软件进行统计分析。
结果
96 例（44.4%）患者行 D1 解剖，120 例（55.6%）行 D2 解剖。当对组进行评估时，D1 组中有 23 例（24.0%）和 D2 组中有 21 例（17.5%）发生了分期转移（P = 0.001）。当对 D1 和 D2 两组进行病理淋巴结数量评估时，尽管 D1 和 D2 两组之间的 N 比没有差异，但在 pN1 和 pN2 组之间发现了统计学上的显著差异（P = 0.047，P = 0.044）。在 D1 中，pN0 的生存率最长，而 pN3 的生存率最短。在 D2 中，pN0 的生存率最长，而 pN3 的生存率最短。
结论
N 比是一种准确的分期系统，用于定义预后和治疗计划，从而减少胃癌分期中的方法学错误。
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