Background/Objectives: The Lymph Node Ratio (LNR) index is the proportion of lymph nodes with present metastases to lymph nodes removed and examined. This is an additionally established parameter for predicting the prognosis of gastric cancer patients. The most popular cancer classification, TNM, describes only the number of affected lymph nodes. It can result in a negative overestimation of the prognosis of patients with gastric cancer if the number of nodes examined is relatively limited. Methods: In this study, we retrospectively analyzed 194 patients diagnosed with gastric cancer operated on between 2017 and 2021 at the Clinical Department of Oncological Surgery, University Centre of General and Oncological Surgery of the University Clinical Hospital in Wroclaw. In total, 133 patients underwent gastrectomy with D2 lymphadenectomy and 61 remaining patients had the resection procedure abandoned due to an unresectable lesion. The LNR index was calculated based on histopathological examination, and postoperative complications were assessed using the Clavien–Dindo (C-D) scale. Statistical analysis was performed regarding the dependence of LNR on the following patient characteristics: sex, age, TNM features, tumor stage, tumor location, performed procedure, chemotherapy application, C-D complication rate, and survival rate. Results: The value of the LNR index significantly depends on TNM features (p< 0.05), clinical tumor stage (p< 0.05), and patient survival (p< 0.05), while no statistically significant relationship with C-D complication rate was demonstrated. Conclusions: The LNR index is a relevant parameter in predicting prognosis and survival time in gastric cancer patients, but future studies on larger and differentiated groups of patients could further confirm its usefulness in the development of guidelines.
背景/目的：淋巴结比率（LNR）指数是指存在转移的淋巴结数量与切除并检查的淋巴结总数之比。这是预测胃癌患者预后的一个额外确立的参数。最常用的癌症分类系统TNM仅描述受累淋巴结的数量。如果检查的淋巴结数量相对有限，可能会导致对胃癌患者预后的负面高估。方法：在本研究中，我们回顾性分析了2017年至2021年间在弗罗茨瓦夫大学临床医院普通与肿瘤外科大学临床中心肿瘤外科临床部接受手术的194例胃癌确诊患者。其中133例患者接受了胃切除术联合D2淋巴结清扫术，其余61例患者因病灶不可切除而放弃切除手术。LNR指数基于组织病理学检查计算得出，术后并发症采用Clavien–Dindo（C-D）量表进行评估。统计分析涉及LNR与以下患者特征的相关性：性别、年龄、TNM特征、肿瘤分期、肿瘤位置、手术方式、化疗应用、C-D并发症发生率及生存率。结果：LNR指数的值显著依赖于TNM特征（p<0.05）、临床肿瘤分期（p<0.05）和患者生存率（p<0.05），而与C-D并发症发生率无统计学显著相关性。结论：LNR指数是预测胃癌患者预后和生存时间的重要参数，但未来在更大规模和多样化的患者群体中进行研究可进一步证实其在指南制定中的实用性。
肿瘤(癌症)患者之家