Deng Ming-Cong, Chen Ken, Bao Qi-Mei, Huang Yi-Xing, Zhang Chun-Kai, Zhong Yu-Ke, He Han-Yi, Zu Dan, Liang Chen, Liu Hai-Dong, Hu Yang-Chan, Liu Guo-Xia, He Yan-Hua, Wu Wei-Xing, Zhou Jing-Nan, Teng Yao-Shu, Jing Ji, Shi Yin, Chung Clive Yik-Sham, Yu Chen-Huan, Du Yi-An, Ye Zu, Cheng Xiang-Dong
Zhejiang Cancer Hospital, Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou 310022, Zhejiang Province, China.
Hangzhou Medical College, Hangzhou 310013, Zhejiang Province, China.
World J Gastroenterol. 2025 Jun 7;31(21):107029. doi: 10.3748/wjg.v31.i21.107029.
The log odds of positive lymph nodes (LODDS) are correlated with survival outcomes in gastric cancer (GC) patients. However, the prognostic value across different tumor differentiation levels remains unclear.
To evaluate the independent prognostic value of LODDS and the stratified predictive efficacy in GC patients with different histologic differentiations.
We conducted a retrospective analysis of 2103 GC patients who underwent radical gastrectomy at Zhejiang Cancer Hospital. The prognostic value of LODDS was compared with that of other lymph node-based metrics, including the pathologic N stage, number of positive lymph nodes, number of total lymph nodes, and lymph node ratio, stratified by tumor differentiation.
LODDS was identified as an independent prognostic factor for overall survival in moderately to poorly differentiated GC patients. LODDS demonstrated superior predictive accuracy over other lymph node metrics. A nomogram incorporating LODDS, age, carbohydrate antigen (CA) 125, carcinoembryonic antigen, and tumor differentiation showed good predictive accuracy (C-index = 0.703). A higher LODDS was significantly associated with an increased risk of recurrence or metastasis, poorly differentiated tumors, advanced cancer, mucinous gastric adenocarcinoma, nerve invasion, and vascular tumor thrombus. Additionally, LODDS was positively correlated with the tumor markers CA19-9, CA72-4, CA125, and CA242 (all < 0.05).
LODDS is an independent prognostic indicator for patients with moderately and poorly differentiated GC, and its predictive performance is superior to that of other models.
阳性淋巴结的对数优势比（LODDS）与胃癌（GC）患者的生存结果相关。然而，其在不同肿瘤分化水平的预后价值仍不清楚。
评估LODDS在不同组织学分化的GC患者中的独立预后价值及分层预测效能。
我们对在浙江省肿瘤医院接受根治性胃切除术的2103例GC患者进行了回顾性分析。将LODDS的预后价值与其他基于淋巴结的指标进行比较，包括病理N分期、阳性淋巴结数量、总淋巴结数量和淋巴结比率，并按肿瘤分化进行分层。
LODDS被确定为中低分化GC患者总生存的独立预后因素。LODDS的预测准确性优于其他淋巴结指标。包含LODDS、年龄、糖类抗原（CA）125、癌胚抗原和肿瘤分化的列线图显示出良好的预测准确性（C指数 = 0.703）。较高的LODDS与复发或转移风险增加、低分化肿瘤、进展期癌症、黏液性胃腺癌、神经侵犯和血管肿瘤血栓显著相关。此外，LODDS与肿瘤标志物CA19-9、CA72-4、CA125和CA242呈正相关（均P < 0.05）。
LODDS是中低分化GC患者的独立预后指标，其预测性能优于其他模型。
