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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 evaluate the accuracy of gastric cancer prognosis by comparing lymph node staging (pN), metastatic lymph node ratio (MLR) and log odds of positive lymph nodes (LODDS) in AJCC / UICC gastric cancer Sex. Methods: ROC curve analysis was performed on 1 247 gastric cancer patients undergoing radical resection with complete follow-up data. The area under curve (AUC) of different gastric cancer lymph node staging was statistically compared with group t test . Results: There was no significant difference in AUC (P> 0.05), but there was no statistical significance between the three samples in the overall sample, T2, T3, Only LODDS had prognostic value in metastasis samples, which was significantly different from that of pN and MLR (P <0.05). Among the samples with lymph node metastasis, three had prognostic value, and the differences of AUC between MLR and LODDS and pN There was statistical significance (P <0.05). Only LODDS in T1 samples had prognostic value, but no significant difference with pN and MLR AUC (P> 0.05). Conclusions: MLR and LODDS outweigh the pN stage in the accuracy of prognosis of gastric cancer. PN and MLR are not suitable for prognosis of early stage gastric cancer. LODDS is the most accurate lymph node staging method to evaluate the prognosis of gastric cancer.