淋巴结比率作为胰腺癌切除术后预后因素的临床影响。

The clinical impact of the lymph node ratio as a prognostic factor after resection of pancreatic cancer.

作者信息

Yamamoto Yusuke, Ikoma Hisashi, Morimura Ryo, Konishi Hirotaka, Murayama Yasutoshi, Komatsu Shuhei, Shiozaki Atsushi, Kuriu Yoshiaki, Kubota Takeshi, Nakanishi Masayoshi, Ichikawa Daisuke, Fujiwara Hitoshi, Okamoto Kazuma, Sakakura Chouhei, Ochiai Toshiya, Otsuji Eigo

机构信息

Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku Kyoto 6028566, Japan.

出版信息

Anticancer Res. 2014 May;34(5):2389-94.

PMID:24778048

Abstract

BACKGROUND

The prognostic value of lymph node (LN) status in patients who underwent resection for pancreatic cancer (PC) was examined in the present study.

PATIENTS AND METHODS

Fifty-six patients who underwent macroscopic curative resection for PC were analyzed. Twelve factors, including the number of LN metastases, LN ratio, and N category according to the Japanese Pancreatic Society classification, were analyzed using univariate and multivariate analysis.

RESULTS

The optimal cut-off value was 0.2 for the LN ratio. Positive surgical margins (p=0.022) and LN ratio ≥0.2 (p=0.017) were identified as independent prognostic factors. Among the 33 patients with regional LN metastasis, patients with LN ratio ≥0.2 had significantly worse prognosis than those with LN ratio <0.2 (median survival time 14 vs. 26 months, p=0.048), however, the differences in survival between those with N1 and those with N2 by Japanese Pancreatic Society classification were not statistically significant (p=0.85).

CONCLUSION

The LN ratio might be more useful than other parameters as a predictor for survival after resection of PC.

摘要

背景

本研究探讨了接受胰腺癌（PC）切除术患者的淋巴结（LN）状态的预后价值。

患者与方法

分析了56例行PC宏观根治性切除术的患者。采用单因素和多因素分析方法，对包括LN转移数量、LN比率以及根据日本胰腺学会分类的N类别在内的12个因素进行了分析。

结果

LN比率的最佳截断值为0.2。切缘阳性（p = 0.022）和LN比率≥0.2（p = 0.017）被确定为独立的预后因素。在33例有区域LN转移的患者中，LN比率≥0.2的患者预后明显差于LN比率<0.2的患者（中位生存时间分别为14个月和26个月，p = 0.048），然而，根据日本胰腺学会分类，N1和N2患者之间的生存差异无统计学意义（p = 0.85）。