肝外胆管癌患者转移淋巴结比率与预后的相关性
Correlation between metastatic lymph node ratio and prognosis in patients with extrahepatic cholangiocarcinoma.
作者信息
Zhang Jian-Wei, Chu Yun-Mian, Lan Zhong-Min, Tang Xiao-Long, Chen Ying-Tai, Wang Cheng-Feng, Che Xu
机构信息
Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
出版信息
World J Gastroenterol. 2015 Apr 14;21(14):4255-60. doi: 10.3748/wjg.v21.i14.4255.
AIM
To investigate the prognostic value of metastatic lymph node ratio (MLNR) in extrahepatic cholangiocarcinoma (ECC) patients undergoing radical resection.
METHODS
Seventy-eight patients with ECC were enrolled. Associations between various clinicopathologic factors and prognosis were investigated by Kaplan-Meier analyses. The Cox proportional-hazards model was used for multivariate survival analysis.
RESULTS
The overall three- and five-year survival rates were 47.26% and 23.99%, respectively. MLNR of 0, 0-0.2, 0.2-0.5, and > 0.5 corresponded to five-year survival rates of 28.59%, 21.60%, 18.84%, and 10.03%, respectively. Univariate analysis showed that degree of tumor differentiation, lymph node metastasis, MLNR, tumor-node-metastasis (TNM) stage, and margin status were closely associated with postoperative survival in ECC patients (P < 0.05). Multivariate analysis showed that MLNR and TNM stage were independent prognostic factors after pancreaticoduodenectomy (HR = 2.13, 95%CI: 1.45-3.11; P < 0.01; and HR = 1.97, 95%CI: 1.17-3.31; P = 0.01, respectively). The median survival time for MLNR > 0.5, 0.2-0.5, 0-0.2, and 0 was 15 mo, 24 mo, 23 mo, and 35.5 mo, respectively. There were statistical differences in survival time between patients with different MLNR (χ(2) = 15.38; P < 0.01).
CONCLUSION
MLNR is an independent prognostic factor for ECC patients after radical resection and is useful for predicting postoperative survival.
目的
探讨转移淋巴结比率（MLNR）在接受根治性切除的肝外胆管癌（ECC）患者中的预后价值。
方法
纳入78例ECC患者。采用Kaplan-Meier分析研究各种临床病理因素与预后之间的关联。采用Cox比例风险模型进行多因素生存分析。
结果
总体三年和五年生存率分别为47.26%和23.99%。MLNR为0、0 - 0.2、0.2 - 0.5和>0.5时，对应的五年生存率分别为28.59%、21.60%、18.84%和10.03%。单因素分析显示，肿瘤分化程度、淋巴结转移、MLNR、肿瘤-淋巴结-转移（TNM）分期和切缘状态与ECC患者术后生存密切相关（P<0.05）。多因素分析显示，MLNR和TNM分期是胰十二指肠切除术后的独立预后因素（HR = 2.13，95%CI：1.45 - 3.11；P<0.01；以及HR = 1.97，95%CI：1.17 - 3.31；P = 0.01）。MLNR>0.5、0.2 - 0.5、0 - 0.2和0的患者的中位生存时间分别为15个月、24个月、23个月和35.5个月。不同MLNR患者的生存时间存在统计学差异（χ(2)=15.38；P<0.01）。
结论
MLNR是ECC患者根治性切除术后的独立预后因素，有助于预测术后生存。
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