摘要
目的:比较AJCC/UICC胃癌淋巴结分期(pN)、淋巴结转移率(metastatic lymph node ratio,MLR)和阳性淋巴结对数比(log odds of positive lymph nodes,LODDS)3种淋巴结分期方法评估胃癌预后的准确性。方法:对1 247例接受根治性切除并具有完整随访资料的胃癌患者进行ROC曲线分析,用成组t检验对不同胃癌淋巴结分期对应的ROC曲线下面积(area under curve,AUC)进行统计学比较。结果:总体样本、T2、T3、淋巴结送检<15枚和送检≥15枚分组样本中,3种淋巴结分期均有预后评估价值,但AUC差异无统计学意义(P>0.05);无淋巴结转移样本中,仅LODDS有预后评估价值,与pN和MLR的AUC差异有统计学意义(P<0.05);有淋巴结转移样本中,3者均有预后评估价值,MLR和LODDS与pN的AUC差异有统计学意义(P<0.05);T1样本中,仅LODDS有预后评估价值,与pN和MLR的AUC差异无统计学意义(P>0.05)。结论:MLR和LODDS在胃癌预后评估准确性方面优于pN分期;pN和MLR不适用于早期胃癌的预后评估;LODDS是评估胃癌预后最准确的淋巴结分期方法。
Objective：To compare the prognostic accuracy among three gastric cancer lymph node staging systems（pN,MLR and LODDS）.Methods：Total 1 247 gastric cancer patients who received radical resection with complete follow-up data were included.ROC curves of Three Lymph Node Staging Systems were plotted and the area under curve（AUC）were statistically analyzed by grouped t test.Results：In the overall sample,samples with T2 or T3 stage,and samples with 〈15 or ≥ 15 nodes retrieved,all the three staging systems had prognostic value,but no statistical difference was found among AUCs of those three staging systems.Only LODDS had prognostic value in the sample without node metastasis and sample with T1 stage.However,in the sample with lymph node metastasis,all three had prognostic value,and the AUC differences between MLR and pN,LODDS and pN were statistically significant.Conclusion：The prognosic accuracy of MLR and LODDS is better than pN;MLR and pN are not able to predict prognosis of early gastric cancer;LODDS is the most accurate lymph node staging system for predicting the prognosis of gastric cancer.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2011年第5期736-741,共6页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省卫生厅科技项目(Z201024)
关键词
胃肿瘤
预后
淋巴结分期
ROC曲线
gastric cancer
prognosis
lymph node staging
ROC curve
