Gao Yong, Wang Kun, Tang Xiao-Xian, Niu Jin-Liang, Wang Jun
Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, People's Republic of China.
Department of Radiology, Shanxi Provincial People's Hospital, Taiyuan, 030012, People's Republic of China.
Cancer Manag Res. 2022 Jun 21;14:2055-2064. doi: 10.2147/CMAR.S352334. eCollection 2022.
The correlation between the preoperative lymph node count (LNC) on multidetector computed tomography (MDCT) and the prognosis of gastric carcinoma (GC) remains to be defined. This research aims to evaluate the prognostic value of LNC on MDCT in GC patients based on tumor-node-metastasis (TNM) staging, using different size criteria for counting.
The clinical data of 126 patients with gastric adenocarcinoma undergoing gastrectomy were retrospectively analyzed. Lymph nodes greater than 8mm and 5mm on MDCT were counted and recorded. The prognostic implications of LNC on MDCT for patient survival were analyzed according to different size criteria for counting and tumor TNM staging.
When 8mm was used as the counting criterion, LNC on MDCT had no significant effect on the overall survival (OS) of the entire cohort. In addition, the OS of T1-T2 GC patients with LNC on MDCT ≥1 was significantly worse than that of patients with LNC on MDCT <1. When 5mm was used as the counting criterion, LNC on MDCT was found to be significantly associated with the OS of the entire cohort. In the subgroup analysis, patients with relatively advanced (T3-T4, N+ and III) GC with LNC on MDCT >7 showed a significantly worse OS than those with LNC on MDCT ≤7. LNC on MDCT >7 with 5mm as the counting criterion and Stage III were independent risk factors for adverse prognosis.
The prognostic value of LNC on MDCT based on different size criteria varies in patients with different stages of GC. LNC of a smaller size (5mm) on MDCT may be a prognostic factor for patients with relatively advanced GC.
多排螺旋计算机断层扫描（MDCT）术前淋巴结计数（LNC）与胃癌（GC）预后之间的相关性尚待明确。本研究旨在基于肿瘤-淋巴结-转移（TNM）分期，采用不同大小标准计数，评估MDCT上LNC对GC患者的预后价值。
回顾性分析126例行胃癌根治术的胃腺癌患者的临床资料。计数并记录MDCT上大于8mm和5mm的淋巴结。根据不同的计数大小标准和肿瘤TNM分期，分析MDCT上LNC对患者生存的预后意义。
以8mm作为计数标准时，MDCT上的LNC对整个队列的总生存期（OS）无显著影响。此外，MDCT上LNC≥1的T1-T2期GC患者的OS明显差于MDCT上LNC<1的患者。以5mm作为计数标准时，发现MDCT上的LNC与整个队列的OS显著相关。在亚组分析中，MDCT上LNC>7的相对晚期（T3-T4、N+和III期）GC患者的OS明显差于MDCT上LNC≤7的患者。以5mm作为计数标准且MDCT上LNC>7以及III期是不良预后的独立危险因素。
基于不同大小标准，MDCT上LNC的预后价值在不同分期的GC患者中有所不同。MDCT上较小尺寸（5mm）的LNC可能是相对晚期GC患者的预后因素。
