中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
2期
137-140
,共4页
阿拉腾宝力德%李医明%刘彩刚%王斌斌%徐惠绵%陈峻青%王舒宝%路平
阿拉騰寶力德%李醫明%劉綵剛%王斌斌%徐惠綿%陳峻青%王舒寶%路平
아랍등보력덕%리의명%류채강%왕빈빈%서혜면%진준청%왕서보%로평
胃肿瘤%淋巴结转移率%肿瘤分期%预后
胃腫瘤%淋巴結轉移率%腫瘤分期%預後
위종류%림파결전이솔%종류분기%예후
Stomach neoplasms%Metastatic lymph node ratio%Neoplasm staging%Prognosis
目的 探讨淋巴结转移率(rN)对胃癌根治术患者预后的评估价值.方法 回顾性分析1980-2006年间中国医科大学附属第一医院肿瘤外科收治的接受根治性手术的710例胃癌患者的临床资料.按淋巴结捡取数目将710例患者分为少于15枚组(327例)和15枚以上(含15枚)组(383例).按淋巴结转移率进行rN分期；按淋巴结转移数量进行pN分期.分别采用Logrank检验和Cox比例风险模型来进行单因素和多因素预后分析.结果 少于15枚组和15枚以上组胃癌患者中位生存时间分别为74个月(95％ CI:55.6～92.4个月)和96个月(95％ CI:77.8～119.2个月),差异无统计学意义(P＞0.05).多因素预后分析显示,rN分期既是少于15枚组(P＜0.01,RR=1.225,95％ CI:1.102～1.362),又是15枚以上组(P＜0.01,RR=1.421,95％ CI:1.269～1.592)胃癌患者的独立预后因素；而pN分期仅仅是少于15枚组胃癌患者的独立预后因素(P＜0.01,RR=1.475,95％ CI:1.168～1.863).采用rN分期系统,相同分期的两组胃癌患者生存时间的差异均无统计学意义(P＞0.05)；而采用pN分期系统,在pN1期患者中少于15枚组患者生存时间明显短于15枚以上组(P＜0.01).结论 淋巴结转移率是影响胃癌预后的独立因素.在判断胃癌预后中,按淋巴结转移率的rN分期不受检出淋巴结数目的限制,较pN分期系统更为可靠.
目的 探討淋巴結轉移率(rN)對胃癌根治術患者預後的評估價值.方法 迴顧性分析1980-2006年間中國醫科大學附屬第一醫院腫瘤外科收治的接受根治性手術的710例胃癌患者的臨床資料.按淋巴結撿取數目將710例患者分為少于15枚組(327例)和15枚以上(含15枚)組(383例).按淋巴結轉移率進行rN分期；按淋巴結轉移數量進行pN分期.分彆採用Logrank檢驗和Cox比例風險模型來進行單因素和多因素預後分析.結果 少于15枚組和15枚以上組胃癌患者中位生存時間分彆為74箇月(95％ CI:55.6～92.4箇月)和96箇月(95％ CI:77.8～119.2箇月),差異無統計學意義(P＞0.05).多因素預後分析顯示,rN分期既是少于15枚組(P＜0.01,RR=1.225,95％ CI:1.102～1.362),又是15枚以上組(P＜0.01,RR=1.421,95％ CI:1.269～1.592)胃癌患者的獨立預後因素；而pN分期僅僅是少于15枚組胃癌患者的獨立預後因素(P＜0.01,RR=1.475,95％ CI:1.168～1.863).採用rN分期繫統,相同分期的兩組胃癌患者生存時間的差異均無統計學意義(P＞0.05)；而採用pN分期繫統,在pN1期患者中少于15枚組患者生存時間明顯短于15枚以上組(P＜0.01).結論 淋巴結轉移率是影響胃癌預後的獨立因素.在判斷胃癌預後中,按淋巴結轉移率的rN分期不受檢齣淋巴結數目的限製,較pN分期繫統更為可靠.
목적 탐토림파결전이솔(rN)대위암근치술환자예후적평고개치.방법 회고성분석1980-2006년간중국의과대학부속제일의원종류외과수치적접수근치성수술적710례위암환자적림상자료.안림파결검취수목장710례환자분위소우15매조(327례)화15매이상(함15매)조(383례).안림파결전이솔진행rN분기；안림파결전이수량진행pN분기.분별채용Logrank검험화Cox비례풍험모형래진행단인소화다인소예후분석.결과 소우15매조화15매이상조위암환자중위생존시간분별위74개월(95％ CI:55.6～92.4개월)화96개월(95％ CI:77.8～119.2개월),차이무통계학의의(P＞0.05).다인소예후분석현시,rN분기기시소우15매조(P＜0.01,RR=1.225,95％ CI:1.102～1.362),우시15매이상조(P＜0.01,RR=1.421,95％ CI:1.269～1.592)위암환자적독립예후인소；이pN분기부부시소우15매조위암환자적독립예후인소(P＜0.01,RR=1.475,95％ CI:1.168～1.863).채용rN분기계통,상동분기적량조위암환자생존시간적차이균무통계학의의(P＞0.05)；이채용pN분기계통,재pN1기환자중소우15매조환자생존시간명현단우15매이상조(P＜0.01).결론 림파결전이솔시영향위암예후적독립인소.재판단위암예후중,안림파결전이솔적rN분기불수검출림파결수목적한제,교pN분기계통경위가고.
Objectives To evaluate the value of the metastatic to examined lymph nodes(rN) ratio in gastric cancer patients who underwent radical resection.Methods In this retrospective study, data were collected from the medical records of 710 patients who underwent radical gastrectomy (R0) for gastric cancer from 1980 to 2006 in the Department of Surgical Oncology at the First Affiliated Hospital of China Medical University.The patients were divided into 2 groups according to the number of examined lymph nodes:Group 1 consisted of 327 patients with ＜15 examined lymph nodes and Group 2 consisted of 383 patients with ≥ 15 lymph nodes,rN categories staging and pN categories were divided separately according to the metastatic lymph node ratio and the examined lymph nodes.The prognostic factors were analyzed by univariate (Log-rank) and multivariate (Cox model) analysis methods.Results The median survival time was 74 months (95％ CI:55.6-92.4 months) in Group 1 and 96 months (95％ CI:77.8-119.2 months) in Group 2,and the difference was not statistically significant (P＞0.05).On multivariate analysis,the N ratio remained as an independent prognostic factor in both Group 1 (P＜0.01,RR=1.225,95％ CI:1.102-1.362) and Group 2 (P＜0.01,RR=1.421,95％ CI:1.269-1.592).However,pN stage was an independent prognostic factor only in Group 1.When the rN ratio classification was applied,there were no significant differences between each categories (P＞0.05).However,the overall survival of patients with pN1 disease in Group 1 was significantly shorter than that in Group 2 according to the pN stage classification(P＜0.01 ).Conclusions The metastatic lymph node ratio is an independent prognostic factor of the prognosis of gastric cancer.The staging system based on metastatic lymph node ratio(rN) is more reliable than the system based on the number of metastatic lymph nodes in the prediction of the prognosis of gastric cancer.
