Impact of lymph node ratio on prognosis of gastric cancer patients
10.3760/cma.j.cn115355-20240724-00369
- VernacularTitle:转移淋巴结比例对胃癌患者预后的影响
- Author:
Yahui MA
1
;
Xiang MIAO
1
Author Information
1. 连云港市立东方医院普外科，连云港 222042
- Publication Type:Journal Article
- Keywords:
Gastric neoplasms;
Age;
Neoplasm metastasis;
Lymph nodes;
Prognosis
- From:
Cancer Research and Clinic
2025;37(9):679-683
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impact of lymph node ratio (LNR) on the prognosis of gastric cancer patients.Methods:A retrospective case series study was conducted. The clinical data of 146 gastric cancer patients who underwent radical surgery and standardized chemotherapy at Lianyungang Department of General Surgery, Lianyungang Municipal Oriental Hospital from January 2015 to January 2019 were retrospectively analyzed. LNR was calculated, and receiver operating characteristic (ROC) curves of LNR were plotted based on overall survival (OS) to find the optimal cut-off value, and the patients were divided into high LNR group and low LNR group according to the cut-off value. The clinicopathological characteristics and prognosis of the two groups of patients were analyzed, and further the survival difference between patients aged ≥ 65 years and <65 years were analyzed in the two groups.Results:Out of 146 patients, 103 were male and 43 were female, with an age of (69±2) years; Pearson correlation analysis showed a positive correlation between the number of metastatic lymph nodes and LNR ( r = 0.899, P < 0.001). There was no significant correlation between the total number of cleared lymph nodes and LNR ( r = -0.069, P = 0.410). The 5-year cumulative OS rate for all patients was 30.1%, with a median OS time of 42.5 months. According to the 5-year OS, the ROC curve of LNR was plotted, and the area under the curve (AUC) of LNR was 0.699 (95% CI: 0.614-0.785, P < 0.001), with the optimal cut-off value of 0.355. LNR was related to age, tumor differentiation degree and TNM staging (all P < 0.05). The results of multivariate Cox regression analysis showed that LNR, age, TNM staging, and tumor differentiation degree were factors affecting the OS of patients. According to Kaplan-Meier analysis, the 5-year OS rate of patients with high LNR was lower than that of patients with low LNR (10.3% vs. 42.0%, χ2 = 69.89, P < 0.001). Among all patients, the 5-year OS rate of patients aged ≥ 65 years was lower than that of patients aged < 65 years (18.8% vs. 50.0%, χ2 = 15.77, P < 0.001). In the high LNR group, the 5-year OS rate of patients aged ≥ 65 years was lower than that of patients aged <65 years (2.3% vs. 33.3%, χ2 = 6.29, P = 0.012); in the low LNR group, the 5-year OS rate of patients aged ≥ 65 years was lower than that of patients aged < 65 years (32.3% vs. 55.9%, χ2 = 4.78, P = 0.029). Conclusions:LNR is an independent prognostic factor for gastric cancer patients, and gastric cancer patients with LNR > 0.355 have poor prognosis. With the same LNR, the prognosis of elderly patients is worse than that of young patients.
