淋巴结阳性转移率对D2根治术后胃癌患者的临床预后意义  

Clinical prognostic significance of the metastatic lymph node ratio in gastric cancer patients after d2 radical resection

作　　者：郭卫平[1] 区广生[1] 陈图锋[1] 郑峰[1] 黄江龙[1] 刘建培[1] 卫洪波[1] 

机构地区：[1]中山大学附属第三医院胃肠外科,广州510630

出　　处：《国际医药卫生导报》2010年第6期641-644,共4页International Medicine and Health Guidance News

摘　　要：目的 胃癌根治术后转移淋巴结的分期是患者重要的预后指标之一，本研究探讨淋巴结阳性转移率（metastatic lymph node ratio，MLR）用于根治术后胃癌患者转移淋巴结的分期并观察其特点。方法我院自2003年至2006年收治的行D2根治手术治疗的胃癌患者203例，将其分别按UICC／AJCC、JGCA和MLR进行转移淋巴结分期，结合其他临床病理指标进行生存分析，从而观察其临床预后意义。结果按转移淋巴结阳性比率（MLR）来划分：MLR0（MLR=0）118例；MLR1（0〈MLR≤22％）53例；MLR2（MLR〉22％）32例。五年生存率分别为：62％（MLR0）；51％（MLRI）24％（MLR2）。通过单因素生存分析，转移淋巴结分期（UICC／AJCC分期、JGCA淋巴结分期、MLR）、肿瘤浸润深度及肿瘤大小均具有显著性差异（P〈0．05）。分别将这三种转移淋巴结分期方式与其他具有统计意义的临床病理因素进行多因素生存分析，结果发现：MLR分期方式在临床预后方面效果更明显。结论MLR是简单易行、可重复性强的转移淋巴结分期方法，弥补了UICC／AJCC分期及JGCA分期在临床应用的不足之处，是胃癌根治术后患者的临床预后指标。Objective Metastatic lymph node staging is an important prognostic indicator of patients with gastric cancer after radical resection, the aim in this study was to investigate metastatic lymph node ratio （MLR） applied for patients with gastric cancer after radical resection and observe its own characteristics. Methods 203 cases of gastric cancer patients after D2 radical surgical treatment were collected from 2003 to 2006 in our hospital, lymph node staging, according to the UICC / AJCC, JGCA and MLR were survival analyzed with other clinicopathological parameters and observe the its clinical prognostic significance. Results The patients with MLR0 （MLR = 0）, MLR1 （0 〈 MLR ≤22%） and MLR2 （MLR 〉 22%） was 118 cases, 53 cases and 32 cases respectively. The 5-year survival rate of the patients withMLR0, MLR1, and MLR2 was 62%, 51%, and 24%, respectively.In addition to the MLR, the UICC/AJCC N category, JGCA n category, tumor stage （pT category）, and tumor diameter significantly influenced the 5-year survival rate, asdetermined by univariate analysis. Multivariate analyses revealed that MLR was the most significant prognostic factor. Conclusions MLR is a simple, reproducible method of staging lymph node metastasis and an important prognostic indicator of patients with gastric cancer after radical resection, making up the shortcomings for the UICC /AJCC and JGCA classification.

关 键 词：胃肿瘤 预后 淋巴结阳性转移率 

分 类 号：R735.2[医药卫生—肿瘤]