Study On The Effect Of Lymph Node Metastasis Rate On The Prognosis Of Patients After Radical Resection Of Gastric Cancer

Objective:1.To determine the independent factors affecting the prognosis of patients after radical resection of gastric cancer.2.To evaluate the clinical value of lymph node metastasis rate in the prognosis of patients with gastric cancer in each N stage.Methods:Collect and sort out 2009.1-2017.12 Clinical and pathological data of patients after radical resection of gastric cancer treated in General surgery of Yan'an Medical Group General Hospital,established gastric cancer database,followed up regularly mainly through mobile phone,drew ROC curve to determine the cut-off point of some risk factors affecting survival rate of gastric cancer patients,and used Kaplan-Meier method to analyze all data.Cox proportional hazard regression model was established to analyze the statistically significant factors to determine the independent risk factors affecting the prognosis of gastric cancer.Finally,stratified analysis was carried out,and the data were stratified according to pN stages.Kaplan-Meier method was used to analyze the effect of lymph node metastasis rate on the prognosis of patients with gastric cancer under different pN stages.Results:1.ROC curve shows that the demarcation points of the age of onset,the time of operation,the amount of intraoperative blood loss and the maximum diameter of the tumor are 60 years old,160 min,245ml,4cm respectively,and the cutoff point of lymph node metastasis rate is 0?1-20%?21%-100%;2.Univariate survival analysis by Kaplan-Meier method showed that there was no significant difference in sex and leukocyte count(P>0.05).There were significant differences in age of onset,location of tumor,number of detected lymph nodes,intraoperative blood loss,maximum diameter of tumor,time of operation,rate of lymph node metastasis,mode of operation,degree of differentiation,number of positive lymph nodes,pT stage,pN stage and platelet count,HB,CEA content,CA19-9 content and CA72-4 content in biochemical examination.3.Multivariate analysis showed that pN stage,pT stage,number of lymph nodes,age,CEA content and operation type were independent prognostic factors affecting the prognosis of patients with gastric cancer.4.Stratified analysis showed that the survival rates of lymph node metastasis in pN1 stage and pN2 stage were significantly different(P<0.05).Conclusion:1.The independent risk factors affecting the prognosis of gastric cancer included age,type of operation,CEA,depth of invasion(PT stage),number of positive lymph node metastasis(pN stage),lymph node metastasis rate(MLR),number of lymph nodes detected.2.The rate of lymph node metastasis(MLR)can be used to evaluate the prognosis of patients with stage PN1 and pN2.