Flatow Virginia, Warner Richard R P, Overbey Jessica, Divino Celia M
From the *Department of Surgery, †Division of Gastroenterology, and ‡Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai Hospital, New York, NY.
Pancreas. 2016 Mar;45(3):342-4. doi: 10.1097/MPA.0000000000000476.
Nodal metastases are an important prognostic factor in survival for patients with carcinoid tumors. However, it is unclear if the current American Joint Committee on Cancer's gastrointestinal carcinoid staging guidelines, which look only at presence or absence of regional metastases (N1/N0), are fully utilizing lymph node data. Some research has indicated that lymph node ratios (LNRs) are powerful predictors of survival. In our study, we evaluated LNR in carcinoid tumors.
Eleven thousand one hundred eighty-nine carcinoid tumors recorded in the Surveillance, Epidemiology, and End Results database between 1988 and 2011 were evaluated. Receiver operating characteristic curves and the area under the receiver operating characteristic curve (AUC) were used to evaluate the ability of nodal involvement or LNR to predict 10-year survival. All analyses were performed using STATA and SAS version 9.3.
Receiver operating characteristic curve analysis indicated that LNR and node positivity were both predictive of 10-year survival, AUC = 0.734, P < 0.0001; AUC = 0.7048, P < 0.0001. Lymph node ratio was 88% specific and 50% sensitive in predicting 10-year survival. N1 was 88% specific and 49% sensitive in predicting 10-year survival.
Our study indicated that LNR is an independent predictor of survival for patients with carcinoid tumors but was no better than N1/N0 for 10-year survival.
淋巴结转移是类癌患者生存的一个重要预后因素。然而，目前美国癌症联合委员会的胃肠道类癌分期指南仅关注区域转移的有无（N1/N0），尚不清楚其是否充分利用了淋巴结数据。一些研究表明，淋巴结比率（LNRs）是生存的有力预测指标。在我们的研究中，我们评估了类癌肿瘤中的LNR。
对1988年至2011年监测、流行病学和最终结果数据库中记录的11189例类癌肿瘤进行了评估。采用受试者工作特征曲线及受试者工作特征曲线下面积（AUC）来评估淋巴结受累或LNR预测10年生存的能力。所有分析均使用STATA和SAS 9.3版软件进行。
受试者工作特征曲线分析表明，LNR和淋巴结阳性均能预测10年生存，AUC = 0.734，P < 0.0001；AUC = 0.7048，P < 0.0001。淋巴结比率在预测10年生存方面的特异性为88%，敏感性为50%。N1在预测10年生存方面的特异性为88%，敏感性为49%。
我们的研究表明，LNR是类癌患者生存的独立预测指标，但在预测10年生存方面并不比N1/N0更好。
