Liu Hong-gen, Liang Han, Deng Jing-yu, Wang Li, Liang Yue-xiang, Jiao Xu-guang
Department of Gastrointestinal Cancer Surgery, Key Laboratory of Cancer Prevention and Treatment of Tianjin City, Tianjin Cancer Hospital, Tianjin Medical University, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Feb;16(2):151-4.
To evaluate the prognostic value of metastatic lymph node ratio (MLR) for gastric cancer patients with less than 15 lymph nodes dissected.
Clinical data of 610 gastric cancer patients undergoing operation in Tianjin Cancer Hospictal from January 2003 to July 2007 were analyzed retrospectively. Patients were divided into two groups: <15 lymph nodes dissected group (n=320) and ≥ 15 lymph nodes dissected group (n=290). MLR was classified based on the following intervals: rN1 ≤ 10%, rN2 10%-30%, rN3 30%-60% and rN4 >60%. Survival was determined by Kaplan-Meier method and difference was assessed by Log-rank test. Multivariate analysis was performed using Cox proportional hazard regression model. Survival rates were compared between two groups in pN and rN stages respectively.
In <15 nodes group, all the survival differences among various rN stages were not significant (all P>0.05), while in same rN stage, all the survival differences among various pN stages were not significant (all P>0.05). Significant differences of 5-year cumulative survival rates were found between the two groups in pN2 and pN3a stage patients (both P<0.05) while no significant differences were found among different rN stages (all P>0.05). Multivariate analysis demonstrated rN stage was an independent prognostic factor for gastric cancer patients with <15 lymph nodes dissected (P=0.012, RR=1.617, 95%CI:1.111-2.354).
The rN staging system based on MLR can predict the prognosis of gastric cancer patients with less than 15 lymph nodes dissected.
评估转移淋巴结比率（MLR）对清扫淋巴结数目少于15枚的胃癌患者的预后价值。
回顾性分析2003年1月至2007年7月在天津医科大学肿瘤医院接受手术的610例胃癌患者的临床资料。患者分为两组：清扫淋巴结数目<15枚组（n=320）和清扫淋巴结数目≥15枚组（n=290）。MLR根据以下区间分类：rN1≤10%，rN2 10%-30%，rN3 30%-60%和rN4>60%。采用Kaplan-Meier法确定生存率，采用Log-rank检验评估差异。使用Cox比例风险回归模型进行多因素分析。分别比较两组患者在pN和rN分期中的生存率。
在清扫淋巴结数目<15枚组中，各rN分期之间的所有生存差异均无统计学意义（均P>0.05），而在相同rN分期中，各pN分期之间的所有生存差异均无统计学意义（均P>0.05）。两组患者在pN2和pN3a期患者的5年累积生存率存在显著差异（均P<0.05），而不同rN分期之间无显著差异（均P>0.05）。多因素分析表明，rN分期是清扫淋巴结数目少于15枚的胃癌患者的独立预后因素（P=0.012，RR=1.617，95%CI：1.111-2.354）。
基于MLR的rN分期系统可预测清扫淋巴结数目少于15枚的胃癌患者的预后。
