Proposal of a new lymph node staging system for gastric cancer: study from two institutions in China
Proposal of a new lymph node staging system for gastric cancer: study from two institutions in China
复制标题
新的胃癌淋巴结分期系统的提议：中国两家机构的研究
DOI：
10.1007/s12032-014-0229-8
复制
发表时间：
2014
期刊：
影响因子：
3.4
通讯作者：
Wang Shan
中科院分区：
文献类型：
--
作者：
Zhang Jizhun;Jiang Kewei;Liu Yong;Ye Yingjiang;Lv Liang;Shen Zhanlong;Zhou Yangbing;Wang Shan
本研究的目的是确定淋巴结分类的最佳分界点，以提高中国胃癌的预后预测。回顾性评价了来自北京大学人民医院（PKUPH，N= 503）和青岛大学附属医院（AHQU，N= 1，003）的两个高容量机构的胃癌手术患者。根据转移淋巴结的数目以每次增加一个淋巴结的方式评估患者的预后。根据淋巴结转移数目与预后的关系，提出了一种新的淋巴结分类法。根据预后价值，建议的淋巴结（N）分期分为N 0（无区域淋巴结转移）、N1（1-3个区域淋巴结转移）、N2（4-6个区域淋巴结转移）和N3（≥7个区域淋巴结转移）。与第7版相比，建议的N分类的风险比稳步合理增加。此外，考克斯回归多因素分析表明，建议的N分类是上级比第7 N分类作为一个独立的预后因素。与美国癌症联合委员会（AJCC）第7版N分类相比，该N分类方法对中国胃癌患者预后的评估具有上级优势。
The aim of this study was to identify the best cutoff points for lymph node classification to improve the prognostic prediction of gastric cancer in China. Patients who had undergone surgery for gastric cancer were retrospectively evaluated in two high-volume institutions from Peking University People’s Hospital (PKUPH,N= 503) and Affiliated Hospital of Qingdao University (AHQU,N= 1,003). The prognosis of these patients was assessed according to the number of metastatic lymph nodes with an increment of one node at one time. A new lymph node classification was proposed based on the relation between prognosis and the number of metastatic lymph nodes. According to the prognostic value, the proposed node (N) stage was categorized as N0(no regional LNs metastasis), N1(1–3 involved regional LNs), N2(4–6 involved regional LNs), and N3(≥7 involved regional LNs). The hazard ratio for the proposed N classification increased steadily and reasonably compared with the 7th edition. Moreover, the Cox regression multivariate analysis showed that the proposed N classification was superior to the 7th N classification as an independent prognostic factor. The proposed N category was superior to 7th edition N category of the American Joint Committee on Cancer (AJCC) for assessing the prognosis for gastric cancer patients in China.