Deng W Y, Wei C, Li N, Zhang Y P, Shen W, Zhang C, Luo S X
Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450000, China.
Zhonghua Yi Xue Za Zhi. 2016 Dec 20;96(47):3829-3832. doi: 10.3760/cma.j.issn.0376-2491.2016.47.013.
To investigate the number of metastatic lymph nodes (pN) and the metastatic lymph node ratio (LNR) on the post-surgical prognosis of patients with esophageal cancer (EC). A retrospective analysis of 573 inpatients diagnosed as esophageal carcinomas from March 2008 to June 2012 was carried out.All pathologic specimen were reviewed by pathologists from Henan Tumor Hospital.The Kaplan-Meier method was used to calculate survival rates, and survival curves were compared with the Log-rank test.The Cox model was employed for multivariate analyses of factors.The association of pN and LNR with prognosis of esophageal cancer was examined by the area under the ROC curve(AUC). The 1-, 3- and 5-year OS rates were 72.5%, 46.1% and 32.3%, respectively.Univariate analysis showed that tumor location(=0.020), tumor length(=0.009), pT stage(=0.011), pN stage(<0.01), and the LNR(<0.01) were prognostic factors for OS.Multivariate analysis indicated that pT stage(=0.047), pN stage(=0.018) and LNR(=0.011) were significant and independent risk factors for poor OS.ROC analysis indicated that LNR (AUC=0.680) had better predictive value than pN (AUC=0.579). The integrated use of LNR and pN may be suitable for evaluation of prognosis in patients with EC and positive nodal metastasis after curative resection.
探讨转移性淋巴结数量（pN）及转移淋巴结比率（LNR）对食管癌（EC）患者术后预后的影响。对2008年3月至2012年6月诊断为食管癌的573例住院患者进行回顾性分析。所有病理标本均由河南省肿瘤医院病理科医生复查。采用Kaplan-Meier法计算生存率，生存曲线采用Log-rank检验进行比较。采用Cox模型对各因素进行多因素分析。通过ROC曲线下面积（AUC）检验pN和LNR与食管癌预后的相关性。1年、3年和5年总生存率分别为72.5%、46.1%和32.3%。单因素分析显示，肿瘤位置（=0.020）、肿瘤长度（=0.009）、pT分期（=0.011）、pN分期（<0.01）及LNR（<0.01）是总生存的预后因素。多因素分析表明，pT分期（=0.047）、pN分期（=0.018）及LNR（=0.011）是总生存不良的显著独立危险因素。ROC分析表明，LNR（AUC=0.680）比pN（AUC=0.579）具有更好的预测价值。LNR和pN联合应用可能适用于评估根治性切除术后有阳性淋巴结转移的EC患者的预后。
