淋巴结比率对接受根治性治疗的淋巴结转移阳性胃癌患者的临床影响。
Clinical Influence of the Lymph Node Ratio on Lymph Node Metastasis-positive Gastric Cancer Patients Who Receive Curative Treatment.
机构信息
Department of Surgery, Yokohama City University, Yokohama, Japan;
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
出版信息
In Vivo. 2022 Mar-Apr;36(2):994-1000. doi: 10.21873/invivo.12792.
BACKGROUND/AIM: The present study investigated the clinical impact of the lymph node ratio (LNR) on overall survival (OS) and recurrence-free survival (RFS) in cancer patients with lymph node metastasis who received curative treatment.
PATIENTS AND METHODS
Eighty-six patients who received curative surgery for gastric cancer between 2000 and 2015, and in whom lymph node metastasis was pathologically confirmed, were included in this study. The LNR was defined as the ratio of the number of metastatic lymph nodes to the total number of harvested lymph nodes.
RESULTS
A lymph node ratio of 0.23 was considered the optimal cutoff point for classification according to OS. Statistically significant differences were observed in the 3- and 5-year OS rates and 3- and 5-year RFS rates. The 3-year and 5-year OS rates in the LNR <0.23 group were 57.6% and 57.6%, respectively, whereas those in the LNR ≥0.23 group were 33.0% and 0% (p<0.001). The 3-year and 5-year RFS rates in the LNR <0.23 group were 45.9% and 43.6%, respectively, whereas those in the LNR >0.23 group were 25.2% and 0% (p=0.002). Regarding the site of first relapse, the incidence rates of peritoneal and lymph node metastasis in the LNR >0.23 group were significantly different in comparison to the LNR <0.23 group.
CONCLUSION
A high LNR was associated with significantly worse OS and RFS in patients who received curative treatment for gastric cancer. The lymph node metastasis status should be utilized in the development of treatment strategies for gastric cancer.
背景/目的：本研究旨在探讨接受根治性治疗的淋巴结转移癌症患者的淋巴结比率（LNR）对总生存（OS）和无复发生存（RFS）的临床影响。
患者和方法
本研究纳入了 2000 年至 2015 年间接受根治性手术治疗且病理证实淋巴结转移的 86 例胃癌患者。LNR 定义为转移淋巴结数与总淋巴结数的比值。
结果
根据 OS 进行分类，LNR=0.23 被认为是最佳截断点。OS、RFS 的 3 年和 5 年生存率及 3 年和 5 年 RFS 率存在显著差异。LNR<0.23 组的 3 年和 5 年 OS 率分别为 57.6%和 57.6%，而 LNR≥0.23 组分别为 33.0%和 0%（p<0.001）。LNR<0.23 组的 3 年和 5 年 RFS 率分别为 45.9%和 43.6%，而 LNR>0.23 组分别为 25.2%和 0%（p=0.002）。就首次复发部位而言，LNR>0.23 组腹膜和淋巴结转移的发生率与 LNR<0.23 组相比差异有统计学意义。
结论
LNR 升高与接受胃癌根治性治疗的患者 OS 和 RFS 显著恶化相关。应将淋巴结转移状态用于制定胃癌治疗策略。
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