胃癌患者淋巴结转移组数与预后相关性分析

  目的  探讨淋巴结转移组数与胃癌患者预后的关系。  方法  将中山大学肿瘤防治中心胃胰科2000年1月至2010年9月间1 009例行胃癌根治术、淋巴结检取超过15枚的患者纳入本研究。淋巴结分组采用日本第13版胃癌处理规约的定义。应用Log rank检验和Cox回归分析探讨淋巴结转移组数(n group, Ng)与预后的相关性。  结果  将淋巴结转移组数分为5组:无淋巴结转移(Ng0)、1组淋巴结转移(Ng1)、2组淋巴结转移(Ng2)、3~5组淋巴结转移(Ng3)、6组及以上淋巴结转移(Ng4), 3年生存率分别为91.6%、84.7%、72.0%、59.6%、43.0%, 5年生存率分别为89.9%、82.4%、66.9%、54.6%、38.3%, 各组间3、5年生存率均有统计学意义(P<0.05)。胃癌患者Ng越高, 5年生存率越低, Ng是胃癌的独立预后因素。  结论  Ng是对于现行UICC N分期的良好补充。 

Correlation between the number of metastasized lymph node groups and the prognosis of gastric cancer patients

  Objective  To investigate the number of metastasized lymph node groups (Ng) and the prognosis of gastric cancer patients.  Methods  Data from 1 009 patients receiving radical gastrectomy in the Cancer Center and with more than 15 lymph nodes retrieved between January 2000 and September 2010 were included in the study.Lymph nodes were grouped by using the definition of the Japanese Research Society for Gastric Cancer (13th Japanese edition).Log-rank test and Cox regression analysis were used to explore the relationship between the Ng and overall survival.  Results  The metastasized lymph nodes were divided into 5 groups:1 group without lymph node metastasis (Ng0), 1 group with lymph node metastasis (Ng1), 2 groups with lymph node metastasis (Ng2), 3 to 5 groups with lymph node metastasis (Ng3), and more than 6 groups with lymph node metastasis (Ng4).The 3-year survival rates were 91.6%, 84.7%, 72.0%, 59.6%, and 43.0% for Ng0, Ng1, Ng2, Ng3, and Ng4, respectively.The 5-year survival rates were 89.9%, 82.4%, 66.9%, 54.6%, and 38.3% for Ng0, Ng1, Ng2, Ng3, and Ng4, respectively.These 3-and 5-year overall survival rates differed significantly among the groups (P<0.05).Gastric cancer patients with high Ng have low 3-year overall survival rates.Ng is an independent prognostic factor of gastric cancer.  Conclusion  The concept of Ng can be a good supplement to existing UICC N staging.