Zhao Yang, Li De-chuan, Lou Rong-can, Chen Wei-ping, Chen Gui-ping, Fan Yong-tian
Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China.
Zhonghua Zhong Liu Za Zhi. 2009 Oct;31(10):764-8.
To investigate the prognostic significance of metastatic lymph node ratio in patients with colorectal cancer.
The clinicopathological data of 303 surgically treated patients with colorectal cancer were retrospectively analyzed. Spearman correlation analysis was used to determine the correlation coefficient. The survival was analyzed using Kaplan-Meier method, and the survival difference was assessed by Log-rank test. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Receiver working characteristic curve was used to compare the accuracy of the metastatic lymph nodes ratio in predicting the death of patients at 5 years postoperatively with that of the number of metastatic lymph nodes.
The MLR was not correlated with the total number of dissected lymph nodes (Spearman correlation coefficient: -0.099, P > 0.05), but the positive rate of metastatic lymph nodes did (correlation coefficient: 0.107, P < 0.05). Kaplan-Meier survival analysis revealed that the MLR significantly influenced the postoperative survival time (Log-rank chi(2) = 42.878, P < 0.01), even in the patients with less than 12 resected lymph nodes. The 5-year survival rates for rN0, rN1, rN2 and rN3 were 90.9%, 68.9%, 54.7% and 39.4%, respectively. There was a significant difference between the different stages (P < 0.01). Cox proportional hazard regression model analysis showed that the metastatic lymph node ratio was an independent prognostic factor. (EXP(B) = 7.809, P < 0.01). There was no significant difference between metastatic lymph node ratio and the number of metastatic lymph nodes in predicting the death of patients at 5 years postoperatively based on the area under the receiver working characteristic curve.
The metastatic lymph node ratio in colorectal cancer patients is not correlated with the total number of dissected lymph nodes. The metastatic lymph node ratio is a major independent prognostic factor for patients with colorectal cancer. The ability of metastatic lymph node ratio in predicting the death of colorectal cancer patients at 5 years postoperatively is the same as that of the number of metastatic lymph nodes.
探讨结直肠癌患者转移淋巴结比率的预后意义。
回顾性分析303例接受手术治疗的结直肠癌患者的临床病理资料。采用Spearman相关分析确定相关系数。采用Kaplan-Meier法分析生存率，并用Log-rank检验评估生存差异。采用Cox比例风险回归模型进行向前逐步回归的多因素分析。使用受试者工作特征曲线比较转移淋巴结比率与转移淋巴结数量在预测患者术后5年死亡方面的准确性。
转移淋巴结比率与清扫淋巴结总数无相关性（Spearman相关系数：-0.099，P>0.05），但转移淋巴结阳性率与之相关（相关系数：0.107，P<0.05）。Kaplan-Meier生存分析显示，转移淋巴结比率显著影响术后生存时间（Log-rankχ²=42.878，P<0.01），即使在切除淋巴结少于12枚的患者中也是如此。rN0、rN1、rN2和rN3患者的5年生存率分别为90.9%、68.9%、54.7%和39.4%。不同分期之间存在显著差异（P<0.01）。Cox比例风险回归模型分析显示，转移淋巴结比率是独立的预后因素（EXP(B)=7.809，P<0.01）。基于受试者工作特征曲线下面积，转移淋巴结比率与转移淋巴结数量在预测患者术后5年死亡方面无显著差异。
结直肠癌患者的转移淋巴结比率与清扫淋巴结总数无关。转移淋巴结比率是结直肠癌患者的主要独立预后因素。转移淋巴结比率预测结直肠癌患者术后5年死亡的能力与转移淋巴结数量相同。
