Zekri Jamal, Ahmad Imran, Fawzy Ehab, Elkhodary Tawfik R, Al-Gahmi Aboelkhair, Hassouna Ashraf, El Sayed Mohamed E, Ur Rehman Jalil, Karim Syed M, Bin Sadiq Bakr
Hepatogastroenterology. 2015 Mar-Apr;62(138):291-4.
BACKGROUND/AIMS: Lymph node ratio (LNR) defined as the number of lymph nodes (LNs) involved with metastases divided by number of LNs examined, has been shown to be an independent prognostic factor in breast, stomach and various other solid tumors. Its significance as a prognostic determinant in colorectal cancer (CRC) is still under investigation. This study investigated the prognostic value of LNR in patients with resected CRC.
We retrospectively ex- amined 145 patients with stage II & III CRC diagnosed and treated at a single institution during 9 years pe- riod. Patients were grouped according to LNR in three groups. Group 1; LNR < 0.05, Group 2; LNR = 0.05-0.19 & Group 3 > 0.19. Chi square, life table analysis and multivariate Cox regression were used for statistical analysis.
On multivariate analysis, number of involved LNs (NILN) (HR = 1.15, 95% CI 1.055-1.245; P = 0.001) and pathological T stage (P = 0.002) were statistically significant predictors of relapse free survival (RFS). LNR as a continuous variable (but not as a categorical variable) was statistically significant predictor of RFS (P = 0.02). LNR was also a statistically significant predictor of overall survival (OS) (P = 0.02).
LNR may predict RFS and OS in patients with resected stage II & III CRC. Studies with larger cohorts and longer follow up are needed to further examine and validate theprognostic value of LNR.
背景/目的：淋巴结比率（LNR）定义为发生转移的淋巴结数量除以检查的淋巴结数量，已被证明是乳腺癌、胃癌和其他多种实体瘤的独立预后因素。其作为结直肠癌（CRC）预后决定因素的意义仍在研究中。本研究调查了LNR在接受CRC切除患者中的预后价值。
我们回顾性研究了9年间在单一机构诊断和治疗的145例II期和III期CRC患者。根据LNR将患者分为三组。第1组：LNR < 0.05，第2组：LNR = 0.05 - 0.19，第3组：LNR > 0.19。采用卡方检验、生命表分析和多变量Cox回归进行统计分析。
多变量分析显示，受累淋巴结数量（NILN）（HR = 1.15，95% CI 1.055 - 1.245；P = 0.001）和病理T分期（P = 0.002）是无复发生存期（RFS）的统计学显著预测因素。LNR作为连续变量（而非分类变量）是RFS的统计学显著预测因素（P = 0.02）。LNR也是总生存期（OS）的统计学显著预测因素（P = 0.02）。
LNR可能预测接受切除的II期和III期CRC患者的RFS和OS。需要进行更大样本量队列和更长随访时间的研究，以进一步检验和验证LNR的预后价值。
