Priolli D G, Cardinalli I Aparecida, Pereira J Aires, Alfredo C Helaehil, Margarido N Fontana, Martinez C A Real
São Francisco University Medical School, São Paulo, Brazil.
Tech Coloproctol. 2009 Jun;13(2):113-21. doi: 10.1007/s10151-009-0467-5. Epub 2009 May 29.
In patients with colorectal cancer, involvement of the lymph nodes is one of the most important prognostic factors. The aim of this study was to determine the independent prognostic value of the lymph node ratio (LNR), that is the relationship between the involved and examined lymph nodes, in patients with colorectal cancer.
Included in the study were 113 patients with colorectal adenocarcinoma. The patients were divided into three groups according to the proportion of involved lymph nodes: LNR-0, when there was no lymph node involvement; LNR-1, when there was involvement of up to 20% of the examined lymph nodes, and LNR-2, when there was involvement of 21% or more of the examined nodes. The relationship between lymph node ratio, the number of lymph nodes removed, and the number of lymph nodes involved by cancer was determined. The 5-year survival was evaluated using the Kaplan-Meier test.
There was a significant difference in 5-year overall between patients in the different LNR groups (p=0.009). Patients in the LNR-0 group had a 5-year overall survival greater than 80%, while those in the LNR-1 and LNR-2 groups had 5-year overall survival rates less than 60% and 40%, respectively. Multivariate analysis demonstrated that the LNR is an independent prognostic variable in 5-year overall survival (p=0.009).
The results showed that the LNR can be considered an independent prognostic variable in overall survival of patients with colorectal cancer.
在结直肠癌患者中,淋巴结受累是最重要的预后因素之一。本研究的目的是确定淋巴结比率(LNR),即受累淋巴结与检查淋巴结之间的关系,在结直肠癌患者中的独立预后价值。
本研究纳入了113例结直肠腺癌患者。根据受累淋巴结的比例将患者分为三组:LNR-0组,无淋巴结受累;LNR-1组,受累淋巴结占检查淋巴结的比例高达20%;LNR-2组,受累淋巴结占检查淋巴结的比例为21%或更多。确定了淋巴结比率、切除淋巴结数量与癌累及淋巴结数量之间的关系。采用Kaplan-Meier检验评估5年生存率。
不同LNR组患者的5年总生存率存在显著差异(p = 0.009)。LNR-0组患者的5年总生存率大于80%,而LNR-1组和LNR-2组患者的5年总生存率分别小于60%和40%。多因素分析表明,LNR是5年总生存率的独立预后变量(p = 0.009)。
结果表明,LNR可被视为结直肠癌患者总生存的独立预后变量。