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At least 325 records · Page 18Linked to original sources
PubMed2003

[Relationship between acid-base disturbance in blood gas analysis and prognosis of patients with severe acute respiratory syndrome].

OBJECTIVE: To study the influence of the acute blood gas analysis index change on the prognosis of patients with severe acute respiratory syndrome (SARS). METHODS: Artery blood gas analysis indexes were determined in 38 of 103 cases of SARS patients during acute stage, the relationship between the change of blood gas analysis index and prognosis of patients with SARS was analyzed. RESULTS: The lower partical pressure of carbon dioxide in artery (PaCO2), partical pressure of oxygen in artery (PaO2) in blood was, the higher death rate was. pH in blood had no significant influence on the prognosis of SARS patients. The prognosis of SARS patients were worse and the death rate was higher when patient had two or more acid-base disturbance. CONCLUSION: The artery blood gas analysis is useful for judging the conditions and prognosis of patients with SARS, and is beneficial for clinical treatment.

Acid-Base Imbalance↗
PubMed2003

[Evaluation oxygen free radicals related index before liver transplantation to forejudge prognosis].

OBJECTIVE: To research the relationship of oxygen free radicals related index before liver transplantation with prognosis. METHODS: Lipid peroxide (LPO), total antioxidant capacity (TAC), nitric oxide (NO) and total bilirubin (T-BIL) in blood from 18 patients were measured before liver transplantation, and the relationship with prognosis was analyzed. RESULTS: The blood LPO of death group was (17.13+/-4.16) micromol/L, it was obviously higher than that of survival group (7.97+/-3.52) micromol/L (P<0.05). The blood TAC of survival group was (38.05+/-19.13) kU/L, it was higher than that of death group (32.54+/-3.07) kU/L, but there was no obvious difference(P>0.05). There was no obvious difference between the blood NO of death group was (50.80+/-14.80) micromol/L, and survive group was (150.46+/-19.54) micromol/L (P>0.05). The blood T-BIL of death group was (425.98+/-214.18) micromol/L, it was obviously higher than that of survival group (172.10+/-144.32) micromol/L (P<0.05). So the blood LPO and TAC were chosen as the index to forejudge prognosis, and an equation was established to forecast if the patient would be death or survive: Y(1)=0.329 0 X(1)+0.099 8 X(2)-3.9040, Y(2)=1.352 0 X(1)-0.0500 X(2)-11.4640, X(1) represented serum LPO, X(2) represented serum TAC. 100.0 percent accuracy was forecasted in the survival group by the equation, 83.3 percent accuracy was in the death group. The overall patients were forejudged 94.4 percent accurately. CONCLUSION: Measuring LPO and TAC in blood maybe forejudging prognosis properly and can be used as routine examination before liver transplantation. The equation is preferable to forejudging prognosis, it can be used to choose from high risk patients to improve survival rate of the patients after operation. Therefore, it is valuable in clinical practise.

Adult↗
PubMed1992

[DNA ploidy pattern as an indicator of degree of malignancy and prognosis in gastric cancer].

We used fresh materials and paraffin blocks of advanced gastric cancer to examine the relationship of DNA ploidy pattern from flow cytometry (FCM) to degree of malignancy and prognosis. No significant relationship was found between the frequency of DNA aneuploid (DA) and the clinicopathological factors (depth of invasion, degree of progression, histological type, lymph node metastasis, ly, v etc.). FCM examination using fresh materials revealed significant difference in prognosis between the non-DA and DA groups for non-curative stage III or IV cases (p < 0.05). On the other hand, in terms of the relationship between DNA ploidy patterns from paraffin blocks and prognosis for curative resection cases of ss-gastric cancer, prognosis was significantly better in the non-DA group than in the DA (p < 0.01). These results indicate that the clinicopathological prognostic factors for gastric cancer are connected in a complex way and that DNA ploidy patterns alone are not superior to the prognosis determining factors used in the past.

Aged↗
PubMed2004

Effect of delays on prognosis in patients with non-small cell lung cancer.

BACKGROUND: The effect of delay on survival in lung cancer remains uncertain. It is suggested that prompt management of non-small cell lung cancer (NSCLC) can influence prognosis. This study was undertaken to examine the relation between delay and prognosis in patients with NSCLC and to investigate the delay time from first symptom and from first hospital visit to start of treatment. METHODS: Two types of delay (symptom to treatment delay and hospital delay) were investigated in 466 patients treated for NSCLC at two institutions in central Sweden. Delays in relation to clinical characteristics were compared and the effects of delay times and other relevant factors on survival were assessed in multivariate analyses. RESULTS: Thirty five per cent of patients received treatment within 4 weeks of the first hospital visit and 52% within 6 weeks. Median symptom to treatment delay was 4.6 months and median hospital delay 1.6 months. Older age, advanced tumour stage, and non-surgical treatment were independently related to poor survival. Both prolonged hospital delay and symptom to treatment delay provided additional information when considered separately. In a final multivariate model only increased symptom to treatment delay gave significant information of a better prognosis. There was an association between a short delay and a poor prognosis which was most pronounced in patients with advanced disease. CONCLUSION: When considering the whole study population and all stages of tumour together, shorter delay was associated with a poorer prognosis. This is likely to reflect the fact that patients with severe signs and symptoms receive prompt treatment. These findings indicate that the waiting time for treatment in patients with NSCLC is longer than recommended.

Adult↗
PubMed2004

[Meta-analysis of relationship between lymph node micrometastasis and prognosis in stage I non-small cell lung cancer patients].

BACKGROUND & OBJECTIVE: Lymph node metastasis is an important factor for prognosis of non-small cell lung cancer (NSCLC). There were different opinions about what effect does lymph node micrometastasis have on prognosis. This study was designed to collect literatures of lymph node micrometastasis and prognosis in stage I NSCLC patients, in order to investigate their relationship. METHODS: The results from eight literatures on lymph node micrometastasis and prognosis from 1980 to 2002 were analyzed synthetically by meta-analysis. The cumulative cases were 536 NSCLC patients with stage I disease. RESULTS: The detection rate of lymph node micrometastasis ranged from 3.4% to 28.9%, and the rate of positive cases ranged from 20% to 70%. The 3-, 5-year over-survival rate for positive lymph node micrometastasis patients was worse than those of negative lymph node micrometastasis patients: odd ratios (ORs) were 4.16 (95%CI:2.32-7.46) and 3.57 (95%CI:2.30-5.53), respectively (P< 0.01). CONCLUSION: Positive lymph node micrometastasis may be an adverse factor for post-operative prognosis of NSCLC stage I patients.

Carcinoma, Non-Small-Cell Lung↗
PubMed2004

[Prognosis of complications after reconstructive surgeries on the aorto-iliac segment].

Evaluation of efficacy of neuronet technologies for prognosis of specific complications after reconstructive surgeries on aorto-iliac segment was made. A learning sample consisted of 500 reconstructive surgeries, a test one - 161. High efficacy of analog neuron nets was revealed. Prognosis of early thrombosis, postoperative bleeding and also of lethal outcome demonstrated better results, mistake of prognosis was 3.7, 1.2 and 4.6%, respectively. Prognosis of infectious complications and long-term outcomes demonstrated worse results, mistake of prognosis was 7.0 and 10.5%, respectively.

Aorta, Abdominal↗
PubMed2004

[Effect of pelvic lymphadenectomy on prognosis of endometrial carcinoma].

OBJECTIVE: To study the associated factors with pelvic lymph node metastasis of endometrial carcinoma and the effect of pelvic lymphadenectomy on prognosis of the disease. METHODS: Totally 102 patients with endometrial carcinoma who underwent pelvic lymphadenectomy (90 patients) or lymph node biopsy (12 patients) in our hospital from Jan 1981 to Dec 2002 were recruited. The relationship between various clinicopathologic factors and pelvic lymph node metastasis was analyzed. Prognosis of ninety patients with pelvic lymphadenectomy was compared with 90 patients without pelvic lymphadenectomy (control group) in the same period. The 5-year survival was calculated by life table method. RESULTS: The incidence of pelvic lymph node metastasis increased in patients with low grade (46%), deep myometrium invasion (42%), cervical involvement (44%), positive peritoneal cytology (52%), adenexal metastasis (75%) and distant spread (100%). The 5-year survival was lower in patients with lymph node metastasis (37%) than that without lymph node metastasis (89%, P < 0.05). Univariate and COX regression analysis demonstrated that pelvic lymphadenectomy did not improve patients' prognosis. The 5-year survival in patients undergoing lymphadenectomy was 78%, and it was 72% in patients without lymphadenectomy. CONCLUSIONS: The high risk factors for pelvic lymph node metastasis in endometrial carcinoma include low grade differentiation deep myometrium invasion, cervical involvement, positive peritoneal cytology, adenexal metastasis and distant spread. The prognosis is poorer in patients with pelvic lymph node metastasis. Pelvic lymphadenectomy could not improve the prognosis of patients with endometrial carcinoma.

Adenocarcinoma, Clear Cell↗
PubMed2004

[Relationship of matrilysin with invasion, metastasis, and prognosis in laryngeal cancer].

BACKGROUND & OBJECTIVE: Matrilysin (matrix metalloproteinases-7, MMP-7) might play an important role in invasion and metastasis of tumor and is thought to be related to prognosis of many kinds of carcinomas. This study was designed to investigate the significance of MMP-7 expression in the invasion and metastasis of laryngeal cancer and the relationship of MMP-7 expression with the prognosis of laryngeal cancer. METHODS: The expression of MMP-7 in 70 samples with paraffin-embedded laryngeal cancer and corresponding para-tumor normal mucosas were using immunohistochemical technique. The mRNA expression of MMP-7 were examined by reverse transcription-polymerase chain reaction (RT-PCR) in 24 frozen specimens of laryngeal cancer and corresponding para-tumor normal mucosas. RESULTS: (1) The immunohistochemical staining of MMP-7 was observed in 77.1% (54/70) of cancer tissues, which was significantly higher than that (5.7%, 4/70) of para-tumor normal mucosas (P< 0.01). The mRNA expression of MMP-7 was detected in 75.0% (18/24) of cancer tissues, which was also significantly higher than that (4.2%, 1/24) of para-tumor normal mucosas (P< 0.01). (2) The expression of MMP-7 in protein level was hot only higher in T3-T4 group than that in T1-T2 group (P< 0.01) but also higher in nodal metastases group than that in group without nodal metastases (P< 0.01). (3) The mRNA expression of MMP-7 was significantly higher in T3-T4 group than that in T1-T2 group (2.908 +/- 0.891 vs.1.662 +/- 0.508, P< 0.01) and was significantly higher in nodal metastases group than that in group without nodal metastases (2.958 +/- 0.827 vs. 1.887 +/- 0.769,P< 0.01). (4) Kaplan-Meier survival curve showed that the prognosis of group with MMP-7 protein high expression was poorer than that in group of MMP-7 protein weak or negative expression (log-rank=4.7559, 8.9513; P=0.0292, 0.0028). No significant difference was found between group with MMP-7 protein weak expression and group with that negative expression (log-rank=0.0314, P= 0.8593). CONCLUSION: MMP-7 possesses close relationship with the invasion, metastasis, and prognosis of laryngeal cancer, and it may be served as a marker in estimating the invasive and metastatic potency and prognosis of laryngeal cancer.

Adult↗
PubMed2004

[Relationship between expression of survivin and prognosis in human laryngeal squamous cell carcinoma].

BACKGROUND & OBJECTIVE: A novel inhibitor of apoptosis Survivin has recently been found in many common human cancers but not in normal tissues. Its potential distribution in human laryngeal squamous cell carcinoma (HLSCC) and its implication for inhibition of apoptosis were not yet very clear. This study was designed to investigate the expression of survivin and the probabilities of using it as a new indicator of the prognosis of HLSCC. METHODS: HLSCC samples from 71 patients treated in Department of Otorhinolaryngology, Second Affiliated Hospital of Sun Yat-sen University between 1995 and 1998 were analyzed for survivin expression by immunohistochemistry method. The patients were followed-up for long term and the relationship between survivin expression and clinical data including age, gender, classification, clinical type, pathological type, lymph node metastasis, distant metastasis, and prognosis were analyzed using software SPSS11.0. RESULTS: The expression rate was 50.7% (36/71) in all 71 cases. The expression rate was 81.8% (9/11) in the cases with lymph nodes metastasis, which was higher than that in the cases without lymph nodes metastasis (45%, 27/60), with significant difference (P=0.025). Univariate analysis revealed that classification,type and survivin expression were significantly related to the prognosis of HLSCC. P value were 0.0001, 0.009, and 0.0008, respectively. Multivariate analysis demonstrated that the patients with positive survivin had significant shorter survival (63.5 months) than those with negative survivin (84.0 months) (P=0.006) except the effect of classification and type on the prognosis of HLSCC. CONCLUSION: Survivin expressed in HLSCC especially in the cases with lymph nodes metastasis. Its expression may related to the prognosis of HLSCC.

Carcinoma, Squamous Cell↗
PubMed2004

Excision repair cross complementing 3 expression is involved in patient prognosis and tumor progression in esophageal cancer.

The prognosis of patients with esophageal cancer remains poor. TNM classification is not sufficient to predict the prognosis. Therefore, novel predictive markers of the prognosis of esophageal cancer patients are awaited. The abnormality of the nucleotide excision repair (NER) is often involved in human cancers. Excision repair cross complementing 3 (ERCC3) contributes to NER. In esophageal cancer, ERCC3 expression has not been studied. Expression of ERCC3 was quantified by real-time reverse transcription polymerase chain reaction (RT-PCR) using LightCycler in 43 primary esophageal squamous cell carcinomas (ESCCs) and their paired normal esophageal mucosa. We examined the correlation between the ERCC3 expression and the clinicopathological factors and prognosis of ESCC patients. ERCC3 expression level was significantly correlated with the pathologic stage, tumor size and local invasiveness (t-factor) in esophageal cancer tissues. Reduced expression of ERCC3 was accompanied with tumor progression (p=0.0049) and higher pathologic stage (p=0.020). Moreover, ESCC patients with low ERCC3 mRNA expression had significantly shorter post-operative survival time than those with high expression (p=0.0003). In esophageal cancer, reduced expression of ERCC3 was correlated with local tumor progression and poor prognosis after operation.

Aged↗
PubMed2004

Relations of proliferative activities of gastric carcinoma cells to lymphatic involvement, venous invasion and prognosis.

BACKGROUND: This study was to evaluate bivariate bromodeoxyuridine (BrdUrd)/DNA flow cytometric analysis in detection of gastric carcinoma and to study the relations of cellular BrdUrd labeling indices (LI), G2/M-phase fraction (G2/MPF) and DNA ploidy pattern to lymphatic involvement, venous invasion and prognosis. METHODS: Fresh tumor samples from 60 patients with gastric carcinoma were analyzed by bivariate BrdUrd/DNA flow cytometry. The results were correlated with lymphatic vessel invasion, lymphatic node metastasis, the number of metastatic lymphatic nodes, and venous invasion. Propidium iodide (PI) was used as a fluorescent probe for total cellular DNA, and a monoclonal antibody against BrdUrd was used as a probe for BrdUrd incorporated into DNA. Fluorescent-labeled goat anti-mouse antibody was used as a second antibody. S-phase fractions were measured by in vitro BrdUrd labeling, and DNA ploidy and G2/MPF were also measured. Comparison of survival was performed with the log-rank test, the Chi-square test for qualitative data, and Student's t test for quantu data. RESULTS: BrdUrd LI and G2/MPF values were significantly higher in tumors with lymphatic vessel invasion than in those without invasion respectively (P < 0.01); the patients who had tumors with lymphatic vessel invasion showed a significantly poor prognosis (P < 0.01). Both BrdUrd LI and G2/MPF values were significantly higher in tumors with lymphatic node metastasis than in those without metastasis (P < 0.01). A statistical significant difference was noted in the 5-year survival rates between the patients with lymph node metastasis and those without metastasis. Compared with diploid carcinoma, the incidence of lymph node metastasis was significantly higher in aneuploid carcinoma (P < 0.05), and the patients with aneuploid carcinoma showed a significantly poor prognosis (P < 0.05). BrdUrd LI was significantly higher in patients with more than 5 metastatic lymph nodes than those with 1 - 4 metastatic lymph nodes (P < 0.05) and those without metastasis (P < 0.01). G2/MPF values in those patients either with more than 5 metastatic lymph nodes or 1 - 4 metastatic lymph nodes were higher than those without metastasis (P < 0.01 and P < 0.05). A statistical significance was seen in the 5-year survival rates among the patients with no metastatic lymph node, 1 - 4 metastatic nodes and more than 5 metastatic nodes (P < 0.01). G2/MPF values were significantly higher in patients with venous invasion than in those without invasion (P < 0.01). CONCLUSIONS: Positive correlations exist between cellular BrdUrd LI, G2/MPF with lymphatic involvement and prognosis, and DNA aneuploid with lymphatic involvement and prognosis. The same was true between G2/MPF value and venous invasion in gastric carcinoma.

Adult↗
PubMed2004

[The model of height prognosis in children with growth hormone deficiency].

The authors present a test for a prognosis of height in children with somatotropic hypofunction of the hypophysis treated with growth hormone. A statistic analysis of the height prognosis was performed on support of a model. With support of the examinations and the received results the following conclusions are proposed: 1. The prognosis of the final height in girls treated with growth hormone was statistically significantly lower than boys. 2. The longer the time of therapy with growth hormone the significantly higher the prognosis of height in these children. 3. In spite of 3 years period of growth hormone therapy even with the dose of 0.7 UJ rhGH the children do not achieve calculated prognosis of height. 4. Further examinations are necessary including more children with total or partial growth hormone deficiency with a longer duration of the observation. 5. An analysis of the final height in children after interruption of the growth hormone therapy at the age of 18 years is necessary.

Adolescent↗
PubMed2005

Nurses' communication of prognosis and implications for hospice referral: a study of nurses caring for terminally ill hospitalized patients.

BACKGROUND: Although nurses are ideally situated to facilitate communication about prognosis and hospice referral among patients, patients' family members, and hospital staff, nurses do not always assume this task. OBJECTIVE: To identify common obstacles to nurses' discussions of prognosis and referral to hospice care with terminally ill patients in the hospital setting. METHODS: Data from a previous study were analyzed. In that study, a total of 174 experienced staff nurses working full-time in hospital practice areas where terminally ill patients routinely receive care at 6 randomly selected community hospitals in Connecticut participated. Each nurse completed a self-administered, cross-sectional survey. In this study, the open-ended responses of the nurses were examined by using content analysis and descriptive analysis. RESULTS: The most common obstacles were unwillingness of a patient or the patient's family to accept the prognosis and/or hospice, sudden death or noncommunicative status of the patient, belief of physicians' hesitance, nurses' discomfort, and nurses' desire to maintain hope among patients and patients' families. CONCLUSIONS: The reasons for noncommunication of prognosis and referral to hospice care by nurses are complex. Because limited discussion between clinicians and patients about prognosis and treatment options can reduce the likelihood of referral to hospice care, improved communication skills may result in more referrals and a smoother transition to hospice.

Attitude of Health Personnel↗
PubMed2004

[Prognosis evaluation and statistical analysis].

With the progress of medical sciences, many new methods and protocols have been developed for clinical diagnosis and treatment. And evaluation of disease prognosis has been emphasized increasingly. Thus, choosing appropriate statistical parameters and analytic methods become more and more important for objective evaluation. This article reviews the parameters used in evaluation of patients' prognosis, influencing factors on prognosis, design of research on prognosis and statistical analysis. The causes for bias and problems needing attention in evaluation of prognosis are also discussed.

Humans↗
PubMed2004

[Research on the basic attributes and psychosocial factors of alcoholics and their families in relation with prognosis after a year of treatment].

Outcomes of a survey by questionnaire on 265 male alcoholics and their 230 families relating basic attributes, psychosocial factors and its correlation with prognosis after a year of inpatient treatment were examined. As for the basic attributes, factors such as family bond, referral for treatment by specialists and the treatment history were correlated with good prognosis . In regard to psychosocial factors, "cohesion" and high level of family function, "denial", family's "obsessive-compulsive traits" were related to positive prognosis. However contrary to preceding studies, "adaptability", "self-acceptance" and "domination trend" were also correlated to good prognosis. In the beginning of treatment, rigid family function were indicated by "adaptability", "domination trend" and "hitting the bottom" occasioned by "self-acceptance", evidenced to be positively correlated to prognosis after a year.

Adaptation, Psychological↗
PubMed2005

[Systemic arterial hypertension in primary chronic glomerulonephritis: prevalence and its influence on the renal prognosis].

UNLABELLED: Nowadays, glomerulonephritis is one of the most common causes of End-stage Renal Disease and starting point of dialysis in Spain. Several factors may influence negatively in this prognosis; among them, we may show up the systemic arterial hypertension. Though its prevalence in the glomerulonephritis is considered higher than in other nephropathies, with variations among series, probably due to difference in ages, in geographical areas, in histological types, in time on evolution of the nephritis ... and because it is difficult to distinguish if the hypertension is a consequence of the nephritis or a consequence of the renal failure that can be present in several cases. In the same way, its negative influence in the renal prognosis may be influenced more by this renal failure, which can be its cause when it is quite severe, than by the hypertension itself. Our aims were to analyse, on the one hand the prevalence of hypertension in the 394 patients diagnosed of primary glomerulonephritis by means of a renal biopsy during two decades in the Bay of Cadiz, as well as its influence in the renal prognosis since the moment of the diagnosis, even with the absence of severe renal failure. We gathered demographic, clinical, analytical and histological data, as well as the situation of the renal function and the survival period of it at the end of each patient study. For the analysis prognosis and renal survival, Kaplan-Meier curves and the long-rank test were used. Of the 394 patients, 247 are men and 147 are women, with an average age of 36.7 +/- 17.7 years old. The global prevalence of hypertension was 39%, with a higher frequency in older patients. The gathered rate of renal survival for hypertensive patients was 54%, 28%, 20% and 4% at 5, 10, 15 and 20 years respectively; while for non-hypertensive patients, it was 83%, 75%, 66% and 62% for the same periods of time (p < 0.001). This worse tendency for hypertensive patients is observed too in each particular histological type, especially in the IgA nephropathy and membranous nephropathy. These results were the same for the patients who did not have severe renal failure in the moment of the biopsy. CONCLUSIONS: Hypertension is a common fact in the primary glomerulonephritis, which also conditions, in an important way, the renal prognosis itself in a long term, from the moment of diagnosis and even before the existence of a significant renal failure.

Adolescent↗
PubMed2005

Semiquantitative 67Ga scintigraphy as an indicator of response to and prognosis after corticosteroid treatment in idiopathic interstitial pneumonia.

UNLABELLED: The prognosis in some forms of idiopathic interstitial pneumonia (IIP), especially idiopathic pulmonary fibrosis (IPF) and fibrotic nonspecific interstitial pneumonia (NSIP), is still poor. A minority of patients will respond to immunosuppressive treatment. In patients with IPF or fibrotic NSIP, pulmonary (67)Ga scintigraphy may be useful for predicting response to therapy and prognosis. The objective of the present study was to evaluate whether semiquantitative (67)Ga scintigraphy can be used to predict responsiveness to therapy with high-dose corticosteroids in a well-defined population of patients with IIP (IPF and fibrotic NSIP). METHODS: This study was performed in a tertiary referral center. We prospectively performed (67)Ga scintigraphy in 23 consecutive patients previously diagnosed with IIP (IPF and fibrotic NSIP) before and after treatment with 3 monthly courses of high-dose methylprednisolone. Lung function tests and bronchoalveolar lavage (BAL) were performed before and after these 3 courses, and patients were monitored for 1 y after the start of the treatment. RESULTS: During follow-up, 5 patients died, none during the first 3 mo. Although pulmonary (67)Ga uptake significantly decreased after treatment (P = 0.001), there was no correlation between either initial (67)Ga uptake or change in (67)Ga uptake on treatment and 1-y prognosis. This finding was independent of prior immunosuppressive treatment, diagnosis of IPF or NSIP, or whether initial (67)Ga uptake was elevated or not. BAL cellularity was correlated with neither pulmonary (67)Ga uptake nor response to treatment. CONCLUSION: Pulmonary (67)Ga uptake cannot be used to predict response to corticosteroid treatment or prognosis in patients with IIP. Apparently, the (inflammatory) process influenced by treatment with methylprednisolone does not determine the progression of disease. This finding supports the hypothesis that although inflammation is present in IPF and fibrotic NSIP, it is neither the hallmark of the disease nor the major factor determining prognosis.

Adrenal Cortex Hormones↗
PubMed2005

[Relationship between metastatic rate and amount of lymph nodes and prognosis of gastric cancer].

OBJECTIVE: to investigate the relationship between metastatic rate and amount of lymph nodes and prognosis of gastric cancer. METHODS: The clinical data of 672 patients of gastric cancer with 22.7 regional metastatic lymph nodes on average were analyzed retrospectively. The patients were divided into 3 groups according to the TNM staging system (1997, 5th edition): pN0 (without metastatic lymph node), pN1 group (with 1-6 metastatic lymph nodes), pN2 group (with 7-15 metastatic lymph nodes), and pN3 group (with more than 215 metastatic lymph nodes), or into 4 groups according to the lymph node metastasis rate: rN0 group (without metastasis of lymph node), rN1 group (with a lymph node metastasis rate 0 < 10%), rN2 group (with a lymph node metastasis rate of 10%-30%), and rN3 group with a lymph node metastasis rate > 30%). The 5-year survival rates of different groups in these 2 classification systems and the relationship between metastatic rate and amount of lymph nodes and prognosis of gastric cancer were analyzed. RESULTS: According to the lymph node metastasis grading system there were 93 patients in the pN0 group, 201 in the pN1 group, 108 in the pN2 group, and 32 in the pN3 group with the 5-year survival rates of 90.3%, 65.2%, 37.0%, and 18.9% respectively (chi(2) = 12.56, P < 0.01). According to the lymph node metastasis system 93 patients were in the rN0 group, 183 in the rN1 group, 92 in the rN2 group, and 66 in the rN3 group, with the 5-year survival rates of 90.3%, 69.9%, 45.7%, and 10.6% respectively (chi(2) = 14.38, P < 0.01). If the cases in the same pN group were re-divided according to the lymph node metastasis rate, there were significant differences in the 5-year survival rate among the new rN groups (chi(2) = 5.26, P = 0.21), and there was a great difference in the distribution of prognosis among different groups. However, if the cases in the same group rN group were re-divided according to the amounts of metastatic lymph nodes, there was no significant difference in 5-year survival rate among different new pN groups (chi(2) = 0.14, P = 0.932). Multivariate COX model analysis showed that the influencing factors of the prognosis were rN grading, pN grading, infiltration depth of cancer, gross type, and size of the cancer, arranged according to the degree of closeness (P < 0.05); lymph nose metastasis rate was closely related with the size, infiltration depth, and gross type of the cancer (P < 0.05). In the same metastasis rate, the 5-year survivals rate decreased along with the increase of the amount of metastatic lymph nodes, and vice versa (chi(2) = 8.22, P = 0.004; chi(2) = 4.52, P = 0.033). CONCLUSION: The staging system based on metastatic lymph node rate is more predictable the number of metastatic lymph nodes for the prognosis of gastric cancer.

Adult↗