pN0期胃癌中淋巴管侵犯的预后意义：一项倾向评分匹配分析

Prognostic significance of lymphovascular invasion in pN0 stage gastric cancer: a propensity score matching analysis.

作者信息

Jiao Xuguang, Wang Yu, Fu Hao, Liu Yongning, Qu Jianjun, Fu Weihua

机构信息

Department of General Surgery, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, P.R. China.

Department of Gastrointestinal Surgery, Weifang People's Hospital, Shandong Second Medical University, Weifang, Shandong, P.R. China.

出版信息

BMC Surg. 2024 Dec 21;24(1):402. doi: 10.1186/s12893-024-02705-8.

DOI:10.1186/s12893-024-02705-8

PMID:39709382

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11662625/

Abstract

BACKGROUND

To explore the potential impact of lymphovascular invasion (LVI) on overall survival (OS) of pN0 stage gastric cancer (GC) after curative resection.

METHODS

A total of 497 GC patients who underwent curative gastrectomy and postoperative pathology proved negative lymph node metastasis between January 2015 and December 2018 in our center were enrolled in this study. All patients were divided into two groups according to the status of LVI. Their clinical and pathological features were compared and potential prognostic factors were analyzed using the propensity score matching analysis (PSM).

RESULTS

Ninety-nine (19.9%) patients had LVI. The presence of LVI was associated with significantly worse survival outcomes in both the overall and PSM cohorts (χ2 = 19.635, p < 0.001; χ2 = 9.367, p = 0.002). After PSM, data of 99 pairs of patients were extracted. Multivariate analysis revealed that number of examined lymph nodes (LNs), and LVI were independent predictors of OS (all p < 0.05). Following stratified analysis, patients with LNs 11-25 and those without LVI tended to have better OS than those with LVI (LNs 11-15: χ2 = 5.019, p = 0.025; LNs 16-25: χ2 = 11.876, p = 0.001).

CONCLUSIONS

pN0 stage GC patients with LVI have poor prognosis. More than 15 lymph nodes need to be dissected to reduce the influence of LVI on the prognosis of pN0 stage GC patients.

摘要

背景

探讨淋巴管侵犯（LVI）对根治性切除术后pN0期胃癌（GC）总生存期（OS）的潜在影响。

方法

本研究纳入了2015年1月至2018年12月在我院接受根治性胃切除术且术后病理证实淋巴结转移阴性的497例GC患者。根据LVI状态将所有患者分为两组。比较两组患者的临床病理特征，并采用倾向评分匹配分析（PSM）分析潜在的预后因素。

结果

99例（19.9%）患者存在LVI。LVI的存在与总体队列和PSM队列中显著更差的生存结果相关（χ2 = 19.635，p < 0.001；χ2 = 9.367，p = 0.002）。PSM后，提取了99对患者的数据。多因素分析显示，检查淋巴结（LNs）数量和LVI是OS的独立预测因素（所有p < 0.05）。分层分析后，LNs为11 - 25个且无LVI的患者的OS往往优于有LVI的患者（LNs 11 - 15：χ2 = 5.019，p = 0.025；LNs 16 - 25：χ2 = 11.876，p = 0.001）。