Díaz Del Arco Cristina, Estrada Muñoz Lourdes, Sánchez Pernaute Andrés, Ortega Medina Luis, García Gómez de Las Heras Soledad, García Martínez Ricardo, Fernández Aceñero Mª Jesús
Complutense University of Madrid, Av. Séneca 2, 28040 Madrid, Spain; Hospital Clínico San Carlos, c/Profesor Martín Lagos s/n, 28040 Madrid, Spain.
Rey Juan Carlos University of Madrid, Av. De Atenas s/n, 28922 Alcorcón, Madrid, Spain; Rey Juan Carlos Hospital, c/Gladiolo s/n, 28933 Móstoles, Mardrid, Spain.
Ann Diagn Pathol. 2021 Feb;50:151677. doi: 10.1016/j.anndiagpath.2020.151677. Epub 2020 Dec 7.
Gastric cancer (GC) shows high recurrence and mortality rates. The AJCC TNM staging system is the best prognostic predictor, but lymph node assessment is a major source of controversy. Recent studies have found that lymph node ratio (LNR) may overcome TNM limitations. Our aim is to develop a simplified tumor-LNR (T-LNR) classification for predicting prognosis of resected GC.
Retrospective study of all GC resected in a tertiary center in Spain (N = 377). Clinicopathological features were assessed, LNR was classified into N0:0%, N1:1-25%, N2:>25%, and a T-LNR classification was developed. Statistical analyses were performed.
317 patients were finally included. Most patients were male (54.6%) and mean age was 72 years. Tumors were intestinal (61%), diffuse (30.8%) or mixed (8.1%). During follow-up, 36.7% and 27.4% of patients progressed and died, respectively. T-LNR classification divided patients into five prognostic categories (S1-S5). Most cases were S1-S4 (26.2%, 19.9%, 22.6% and 23.6%, respectively). 7.6% of tumors were S5. T-LNR classification was significantly associated with tumor size, depth, macroscopical type, Laurén subtype, signet ring cells, histologic grade, lymphovascular invasion, perineural infiltration, infiltrative growth, patient progression and death. Kaplan-Meier curves for OS showed an excellent patient stratification with evenly spaced curves. As for DFS, T-LNR classification also showed good discriminatory ability with non-overlapping curves. T-LNR classification was independently related to both OS and DFS.
T-LNR classifications can successfully predict prognosis of GC patients. Larger studies in other geographic regions should be performed to refine this classification and to validate its prognostic relevance.
胃癌（GC）具有较高的复发率和死亡率。美国癌症联合委员会（AJCC）的TNM分期系统是最佳的预后预测指标，但淋巴结评估是一个主要的争议来源。最近的研究发现，淋巴结比率（LNR）可能克服TNM的局限性。我们的目的是开发一种简化的肿瘤-LNR（T-LNR）分类方法，用于预测接受手术切除的GC患者的预后。
对西班牙一家三级中心切除的所有GC患者进行回顾性研究（N = 377）。评估临床病理特征，将LNR分为N0：0%、N1：1-25%、N2：>25%，并制定T-LNR分类。进行统计分析。
最终纳入317例患者。大多数患者为男性（54.6%），平均年龄为72岁。肿瘤类型为肠型（61%）、弥漫型（30.8%）或混合型（8.1%）。随访期间，分别有36.7%和27.4%的患者病情进展和死亡。T-LNR分类将患者分为五个预后类别（S1-S5）。大多数病例为S1-S4（分别为26.2%、19.9%、...
