淋巴结转移率对各pT分期胃癌患者预后的评估价值  

Prognostic value of metastatic lymph node ratio in gastric cancer patients by T stage

作　　者：李小宝[1] 梅乐园[1] 刘斌[1] 白铁成[1] 李晓勇[1] 刘勇峰[1] 白忠学[1] 高峰[1] 车向明[2] 

机构地区：[1]延安大学附属医院普外科,陕西省716000 [2]西安交通大学医学院附属第一医院普外科,陕西省716000

出　　处：《中华普通外科杂志》2015年第1期31-34,共4页Chinese Journal of General Surgery

基　　金：延安大学附属医院研究生创新基金资助项目（12JJ06）

摘　　要：目的探讨淋巴结转移率（metastatic lymph nodes ratio，MLR）对各pT分期胃癌患者预后的评估价值。方法回顾性分析535例接受手术治疗胃癌患者的临床资料，将MLR与UICC／AJCCpN分期对胃癌患者预后的评价价值进行比较，确定MLR分期方法的特点及优势。分层分析MLR对各个pT分期胃癌患者预后的评价价值。结果单因素生存分析方法将MLR分为4期：MLR0（0）、MLRl（1％-9％）、MLR2（10％～20％）、MLR3（ 〉20％），各期患者的5年生存率分别为69．7％、63．5％、31．7％、28．6％，差异有统计学意义（P〈0．01），MLR分期越高预后越差。单因素Kaplan-Meier法生存分析显示，MLR与患者预后密切相关；多因素COX比例风险回归模型分析显示，MLR是胃癌患者预后的主要独立危险因素。MLR预测胃癌患者术后5年死亡与否的ROC曲线下面积与pN分期相比差异无统计学意义。MLR对pT2和pT3期胃癌预后有较好的评估价值，差异有统计学意义（P〈0．05）。结论MLR是胃癌预后的独立因素，预测胃癌患者预后的准确性较pN分期系统更为可靠，特别是对pT2-pT3期胃癌患者的预后有较好的评估价值。Objective To evaluate the prognostic value of metastatic lymph node ration （MLR） in gastric cancer patients by T stage. Methods Clinical data of 535 patients with gastric cancer undergoing radical gastrectomy and lymphadenectomy were reviewed. MLR classification was compared with pN classification in terms of the accuracy and valid value. The MLR in T stage patients were analyzed retrospectively. Results The MLR was assessed in 4 categories ： 0, 0. 01 - O. 09,0. 1 - 0. 2, 〉 0. 2. Kaplan-Meier survival analysis showed that MLR significantly influenced the postoperative survival time and Cox proportional hazard regression model analysis showed MLR was an independent poor prognostic factor. There was no significant difference between the area under the receiver working characteristic curve of MLR and metastatic lymph nodes number in predicting patients 5 year death postoperatively. Conclusions MLR is an independent prognostic factor of patients with gastric cancer. MLR is more reliable factor in predicting the prognosis of gastric cancer patients than the number of metastatic lymph nodes, especially for T2-T3 stage gastric cancer patients.

关 键 词：胃肿瘤 淋巴转移 肿瘤分期 预后 

分 类 号：R736.1[医药卫生—肿瘤]