基于淋巴结比率的45岁以上病人胃癌分期的新方法  

A new method for staging gastric cancer in patients over 45 years old based on the lymph node ratio

作　　者：王后红 谢宗玉[2] 朱博[3] 何新阳 WANG Hou-hong;XIE Zong-yu;ZHU Bo;HE Xin-yang(Department of Oncology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;Department of Radiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;Department of Pathology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;Department of Gastrointestinal Surgery,The First Affiliated Hospital of University of Science and Technology of China,Hefei Anhui 230000,China)

机构地区：[1]蚌埠医学院第一附属医院肿瘤外科,安徽蚌埠233004 [2]蚌埠医学院第一附属医院放射科,安徽蚌埠233004 [3]蚌埠医学院第一附属医院病理科,安徽蚌埠233004 [4]中国科学技术大学附属第一医院胃肠外科,安徽合肥230000

出　　处：《蚌埠医学院学报》2021年第9期1173-1177,共5页Journal of Bengbu Medical College

基　　金：浙江省医药卫生科技课题(2017178699);浙江省医药卫生科技课题(2018255136);浙江省自然科学基金(Y19H030056);中国科学技术大学青年基金(2020YJQN016)。

摘　　要：目的:评估淋巴结比率(LNR)作为45岁以上胃癌病人分期评估的实用性。方法:接受根治性胃切除术的45岁以上病人236例,收集包括回收的淋巴结(LN)和转移性淋巴结(LNs)的临床病理数据,并计算LNR值(LNR=LNs/LN)。根据危险比(HR)增加的截止点,将间隔为0.1的LNR组分为4个阶段。进行生存分析以评估LNR的预后价值。结果:4个LNR级包括LNR0(n=89),LNR1(n=47),LNR2(n=90)和LNR3(n=10)。在多变量分析中,N分期和LNR分期均显示出显著的预后价值,可预测生存结果。LNR分期在连续阶段之间的HR的增量变化大于N分期(HR:N分期为1.583、2.789和4.581;LNR分期为1.469、3.837和8.572)。结论:LNR分期作为一种新颖且简单的评估方法,在预测45岁以上胃癌病人的预后和复发方面具有一定的临床应用价值。Objective:To evaluate the utility of lymph node ratio(LNR)in the staging assessment of patients over 45 years old with gastric cancer.Methods:The patients aged 45 years or older treated with radical gastrectomy were investigated,the clinicopathological data of recovered lymph nodes(LN)and metastatic lymph nodes(LNs)were collected,and the LNR values were obtained(LNR=LNs/LN).The LNR group with 0.1 intervals was divided into four phases based on the cutoff point of increased hazard ratio(HR).The survival analysis was performed to assess the prognostic value of LNR.Results:The four LNR levels included the LNR0(n=89),LNR1(n=47),LNR2(n=90)and LNR3(n=10).In the multivariate analysis,both N staging and LNR staging showed the significant prognostic value,and which could predict the survival outcome.The incremental changes in the HR among successive stages of LNR staging were greater than those of N staging(HR:the N staging was 1.583,2.789 and 4.581,and the LNR staging was 1.469,3.837 and 8.572).Conclusions:The LNR staging,a novel and simple marker,has certain clinical application value in predicting the prognosis and recurrence of gastric cancer in patients over 45 years old.

关 键 词：胃肿瘤 淋巴结比率 预后 

分 类 号：R735[医药卫生—肿瘤]