Chen Jianhui, Chen Chuangqi, He Yulong, Wu KaiMing, Wu Hui, Cai Shirong
Gastric Cancer Center, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China.
J Gastrointest Surg. 2014 Dec;18(12):2080-8. doi: 10.1007/s11605-014-2663-5. Epub 2014 Oct 9.
Our aim was to establish a new pN staging system for gastric cancer based on the number and location of metastatic lymph nodes (MLNs) and to compare it with other systems.
We retrospectively analyzed the prognostic data of 521 gastric cancer patients who underwent curative resection. Survival analyses were used to establish a pN staging system that considers both the number and location of MLNs and to compare discriminatory ability and monotonicity of gradients (linear trend χ (2) score), homogeneity ability (likelihood ratio test), and prognostic stratification ability (Akaike information criterion) between Japanese Gastric Cancer Association (JGCA) and Union for International Cancer Control (UICC) systems.
Cut-point survival analysis divided pN(+) patients into two groups: Nxn16 and Nxn≥7. N0, N1, N2, and N3 (the previous classifications) were replaced by N0, N1n16, N2n16, and N1n≥7 + N2n≥7 + N3n16 + N3n≥7, respectively. Compared with two widely used staging systems, the new system had the highest likelihood ratio test [106.06 (new) vs 95.09 (JGCA) vs 94.33 (UICC)] and linear trend χ (2) scores [102.30 (new) vs 89.12 (JGCA) vs 86.97(UICC)] and the lowest Akaike information criterion (AIC) score [2,283.88 (new) vs 2,285.31 (JGCA) vs 2,299.88 (UICC)].
A new pN staging system based on the number and location of MLNs is an efficient prognostic indicator of the survival of patients with gastric cancer following radical surgery.
我们的目的是基于转移性淋巴结（MLN）的数量和位置建立一种新的胃癌pN分期系统，并将其与其他系统进行比较。
我们回顾性分析了521例行根治性切除的胃癌患者的预后数据。采用生存分析建立一个同时考虑MLN数量和位置的pN分期系统，并比较日本胃癌协会（JGCA）和国际癌症控制联盟（UICC）系统之间的鉴别能力、梯度单调性（线性趋势χ²评分）、同质性能力（似然比检验）和预后分层能力（赤池信息准则）。
切点生存分析将pN（+）患者分为两组：Nxn16和Nxn≥7。N0、N1、N2和N3（以前的分类）分别被N0、N1n16、N2n16和N1n≥7 + N2n≥7 + N3n16 + N3n≥7取代。与两种广泛使用的分期系统相比，新系统具有最高的似然比检验[106.06（新）对95.09（JGCA）对94.33（UICC）]和线性趋势χ²评分[102.30（新）对89.12（JGCA）对86.97（UICC）]以及最低的赤池信息准则（AIC）评分[2,283.88（新）对2,285.31（JGCA）对2,299.88（UICC）]。
基于MLN数量和位置的新pN分期系统是胃癌根治术后患者生存的有效预后指标。
