Department of General Surgery, Zhongxing Branch, Taipei City Hospital, No. 145, Zhengzhou Road, Datong District, Taipei, 100, Taiwan.
World J Surg. 2012 Aug;36(8):1906-14. doi: 10.1007/s00268-012-1568-2.
Though lymph node status may predict long-term outcome of patients with non-metastatic colon cancer, discordant findings exist among various expressions of lymph node status. The present study was designed to assess the prognostic value among these lymph node evaluations.
The analysis was based on surgical patients with newly diagnosed colon adenocarcinoma registered in the Taiwan Cancer Database from 2003 to 2005. Exclusion criteria included those patients who had stage IV disease, those whose survival period was <1 month, or those whose lymph node information was unavailable. Studied variables included total number of lymph nodes (LNT), number of positive lymph nodes (LNP), number of negative lymph nodes (LNN), ratio of positive lymph nodes (LNR), and log odds of positive lymph nodes (LODDS).
Of 16,790 newly diagnosed colon cancer patients, there were 9,644 (65.4 ± 13.5 years; male 54.9 %) patients with non-metastatic disease who met the criteria. Correlation analyses for patients with stage III disease showed that LNR and LODDS were highly correlated, as were LNT and LNN. By the Cox proportional hazard model, LNT was prognostic of long-term survival in patients with stage II disease, while LNR and LNP were the most powerful prognosticators for patients with stage III disease (p < 0.001). Both the receiver operating characteristics curve analysis and area under the curve indicated that LNR had the best discriminating capability to predict 5-year survival (0.704, 0.700, and 0.709 for overall, disease-free, and disease-specific survival, respectively), followed by LODDS.
For patients undergoing resection for colon cancer, LNR, LODDS, and LNP are better prognostic factors for those with stage III disease than LNT is for patients with stage III disease.
尽管淋巴结状态可能预测非转移性结肠癌患者的长期预后，但各种淋巴结状态的表达存在不一致的发现。本研究旨在评估这些淋巴结评估之间的预后价值。
该分析基于 2003 年至 2005 年在台湾癌症数据库中登记的新诊断为结肠腺癌的手术患者。排除标准包括患有 IV 期疾病的患者、生存期<1 个月的患者或淋巴结信息不可用的患者。研究变量包括总淋巴结数（LNT）、阳性淋巴结数（LNP）、阴性淋巴结数（LNN）、阳性淋巴结比（LNR）和阳性淋巴结对数优势比（LODDS）。
在 16790 例新诊断的结肠癌患者中，有 9644 例（65.4±13.5 岁；男性 54.9%）患有符合标准的非转移性疾病。对 III 期疾病患者的相关性分析显示，LNR 和 LODDS 高度相关，LNT 和 LNN 也高度相关。通过 Cox 比例风险模型，LNT 是 II 期疾病患者长期生存的预后因素，而 LNR 和 LNP 是 III 期疾病患者最有力的预后因素（p<0.001）。受试者工作特征曲线分析和曲线下面积均表明 LNR 具有预测 5 年生存率的最佳区分能力（总生存率、无病生存率和疾病特异性生存率分别为 0.704、0.700 和 0.709），其次是 LODDS。
对于接受结肠癌切除术的患者，LNR、LODDS 和 LNP 是 III 期疾病患者比 LNT 更好的预后因素。
