Mukai Masaya, Sato Shinkichi, Ninomiya Hiromi, Kimura Tomomi, Komatsu Nobukazu, Tajima Takayuki, Nakasaki Hisao, Makuuchi Hiroyasu
Department of Surgery, Tokai University Oiso Hospital, Oiso, Kanagawa 259-0198, Japan.
Oncol Rep. 2004 Dec;12(6):1305-8.
This study compared the prediction of recurrence based on detection of occult neoplastic cells (ONCs) in lymph nodes or using 3 criteria to identify high-risk patients among 72 patients who had Dukes' A colorectal cancer with or without proper muscle invasion. Predicting recurrence based on the detection of ONCs had a sensitivity of 40.0% (2/5) and a false-negative rate of 60.0% (3/5), while there was a specificity of 97.0% (65/67) and false-positive rate of 3.0% (2/67), resulting in an accuracy of 68.5%, PPV of 50.0% (2/4), and NPV of 95.6% (65/68). Predicting recurrence based on the presence of at least 2 of the 3 high-risk criteria showed a sensitivity of 60.0% (3/5) and a false-negative rate of 40.0% (2/5), while it had a specificity of 74.6% (50/67) and a false-positive rate of 25.4% (17/67), resulting in an accuracy of 67.3%, PPV of 15.0% (3/20), and NPV of 96.2% (50/52). These results suggest that a prediction based on ONCs was similar to use of the high-risk criteria, with both methods having a high specificity for recurrence/metastasis of Dukes' A colorectal cancer.
本研究比较了基于检测淋巴结中隐匿性肿瘤细胞（ONCs）或使用3项标准来识别高危患者这两种方法对复发的预测情况，研究对象为72例患有Dukes'A期结直肠癌且有或无固有肌层浸润的患者。基于ONCs检测预测复发的灵敏度为40.0%（2/5），假阴性率为60.0%（3/5），而特异性为97.0%（65/67），假阳性率为3.0%（2/67），准确率为68.5%，阳性预测值为50.0%（2/4），阴性预测值为95.6%（65/68）。基于3项高危标准中至少2项的存在来预测复发的灵敏度为60.0%（3/5），假阴性率为40.0%（2/5），而特异性为74.6%（50/67），假阳性率为25.4%（17/67），准确率为67.3%，阳性预测值为15.0%（3/20），阴性预测值为96.2%（50/5）。这些结果表明，基于ONCs的预测与使用高危标准相似，两种方法对Dukes'A期结直肠癌的复发/转移均具有较高的特异性。
