转移性淋巴结比率可预测结肠癌患者的生存率。
The metastatic lymph node ratio predicts survival in colon cancer.
作者信息
Schumacher Paul, Dineen Sean, Barnett Carlton, Fleming Jason, Anthony Thomas
机构信息
Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, MC-9155, Dallas, TX 75390-9155, USA.
出版信息
Am J Surg. 2007 Dec;194(6):827-31; discussion 831-2. doi: 10.1016/j.amjsurg.2007.08.030.
BACKGROUND
Lymph node metastases are the most important predictor of survival in non-stage IV colon cancer. Recent studies of gastric cancer have shown a prognostic significance of a lymph node ratio (number of positive nodes divided by total number harvested). Our goal was to determine whether a lymph node ratio (LNR) would predict disease-free survival (DFS) and overall survival (OS) in a tertiary care Veterans Affairs medical center.
METHODS
A retrospective review of a prospectively collected database of colon cancer patients was performed to determine the effect of LNR on DFS and OS. A cohort of 232 patients with non-stage IV colon cancer was eligible for analysis. Survival curves were constructed using the Kaplan-Meier method.
RESULTS
For all patients, a LNR of .08 was identified as a breakpoint for predicting OS and DFS. Specific analysis of stage III patients revealed that a LNR of .18 was predictive of DFS.
CONCLUSIONS
This study showed the prognostic significance of ratio-based staging for colon cancer and may aid in future staging systems.
背景
淋巴结转移是非IV期结肠癌生存的最重要预测指标。近期对胃癌的研究显示了淋巴结比率（阳性淋巴结数除以获取的淋巴结总数）的预后意义。我们的目标是确定在一家三级医疗退伍军人事务医疗中心，淋巴结比率（LNR）是否能预测无病生存期（DFS）和总生存期（OS）。
方法
对前瞻性收集的结肠癌患者数据库进行回顾性分析，以确定LNR对DFS和OS的影响。232例非IV期结肠癌患者队列符合分析条件。采用Kaplan-Meier法构建生存曲线。
结果
对所有患者而言，LNR为0.08被确定为预测OS和DFS的分界点。对III期患者的具体分析显示，LNR为0.18可预测DFS。
结论
本研究显示了基于比率分期对结肠癌的预后意义，可能有助于未来的分期系统。
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