CAJ | 학술논문

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%(MLR);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.
목적 위암근치술후전이림파결적분기시환자중요적예후지표지일,본연구탐토림파결양성전이솔(metastatic lymph node ratio,MLR)용우근치술후위암환자전이림파결적분기병관찰기특점.방법 아원자2003년지2006년수치적행D2근치수술치료적위암환자203례,장기분별안UICC/AJCC、JGCA화MLR진행전이림파결분기,결합기타림상병리지표진행생존분석,종이관찰기림상예후의의.결과 안전이림파결양성비솔(MLR)래화분:MLR0(MLR=0)118례;MLR1(0<MLR≤22%)53례;MLR2(MLR>22%)32례.오년생존솔분별위:62%(MLR0);51%(MLR);24%(MLR2).통과단인소생존분석,전이림파결분기(UICC/AJCC분기、JGCA림파결분기、MLR)、종류침윤심도급종류대소균구유현저성차이(P<0.05).분별장저삼충전이림파결분기방식여기타구유통계의의적림상병리인소진행다인소생존분석,결과발현:MLR분기방식재림상예후방면효과경명현.결론 MLR시간단역행、가중복성강적전이림파결분기방법,미보료UICC/AJCC분기급JGCA분기재림상응용적불족지처,시위암근치술후환자적림상예후지표.
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 withMLRO, MLRl, 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.