Zhang Limin, Ma Yan, Liu Bao
Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, China.
The First Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150081, China.
Cancers (Basel). 2023 Jun 13;15(12):3170. doi: 10.3390/cancers15123170.
The lymph-node staging system can predict the prognosis of gastric signet-ring-cell carcinoma (SRCC). However, there are significant differences in lymph-node status between early SRCC and advanced SRCC. Additionally, the optimal system for early and advanced SRCC remains unknown.
This study retrospectively analyzed 693 SRCC patients who underwent radical resection in the Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital. The predicted performance of three lymph-node staging systems, including pN staging, lymph-node metastasis rate (LNR), and log odds of positive lymph nodes (LODDS), was compared using the receiver characteristic operating curve (ROC) and c-index. The Kaplan-Meier method and the log-rank test analyzed the overall survival of patients. The Cox risk regression model identified independent risk factors associated with patient outcomes. The nomogram was made by R studio.
The 693 SRCC included 165 early SRCC and 528 advanced SRCC. ROC showed that LODDS had better predictive performance than pN and LNR in predicting prognosis regardless of early or advanced SRCC. LODDS can be used to predict the prognosis of early and advanced SRCC and was an independent risk factor associated with patient outcomes ( = 0.002, < 0.001). Furthermore, the nomogram constructed by LODDS and clinicopathological features had good predictive performance.
LODDS showed clear prognostic superiority over both pN and LNR in early and advanced SRCC.
淋巴结分期系统可预测胃印戒细胞癌（SRCC）的预后。然而，早期SRCC和进展期SRCC的淋巴结状态存在显著差异。此外，早期和进展期SRCC的最佳分期系统仍不明确。
本研究回顾性分析了哈尔滨医科大学附属肿瘤医院胃肠外科693例行根治性切除术的SRCC患者。使用受试者工作特征曲线（ROC）和c指数比较了三种淋巴结分期系统（包括pN分期、淋巴结转移率（LNR）和阳性淋巴结对数比（LODDS））的预测性能。采用Kaplan-Meier法和对数秩检验分析患者的总生存期。Cox风险回归模型确定与患者预后相关的独立危险因素。列线图由R studio制作。
693例SRCC患者中，早期SRCC 165例，进展期SRCC 528例。ROC显示，无论早期还是进展期SRCC，LODDS在预测预后方面比pN和LNR具有更好的预测性能。LODDS可用于预测早期和进展期SRCC的预后，是与患者预后相关的独立危险因素（ = 0.002， < 0.001）。此外，由LODDS和临床病理特征构建的列线图具有良好的预测性能。
在早期和进展期SRCC中，LODDS在预后方面明显优于pN和LNR。
