Wang Shengguang, Zhang Bin, Li Chenguang, Cui Chao, Yue Dongsheng, Shi Bowen, Zhang Qiang, Zhang Zhenfa, Zhang Xi, Wang Changli
Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China.
Tianjin Lung Cancer Center, Tianjin, 300060, China.
Oncotarget. 2017 May 24;8(45):79387-79396. doi: 10.18632/oncotarget.18154. eCollection 2017 Oct 3.
The definitive validation evidence of the implications of lymph node metastases regarding the survival of Non-Small Cell Lung Cancer (NSCLC) patients is lacking. We aimed to evaluate the prognostic impact of several lymph node metastases-associated risk factors including Number of Negative Lymph Node (NLN) and risk-stratify NSCLC patients into subsets with different prognosis.
A total of 482 patients with N1 and N2 NSCLC were included in this study. The prognostic importance of a set of risk factors was examined by univariate and multivariate analysis. The cut-off points and 5 years survival rates were calculated to test the best grouping system to stratify the patients with difference outcome.
Our analysis indicated that both Ratio of the Metastatic Lymph nodes (RML) and Number of Negative Lymph Node (NLN) were associated with overall survival (OS) and disease free survival (DFS). RML percentage 20% and 55%, and NLN counts 10 and 30 were proved as the optimal cut-off points to predict OS by classifying patients into 3 groups, respectively. RML and NLN actually are more powerful in predicting survival outcome for male patients compared to female patients. Stratified survival analyses using combined factors indicated that the 5-year survival rate (5-YSR) is high in RML I + NLN I/III subgroup (5-YSR = 57.1% and 43.3%) and low in RML III + NLN II/III subgroup (5-YSR = 0.0 % each).
NLN is a strong prognostic factor for OS and DFS of stage II/IIIa NSCLC patients, and provides a useful classification scheme for NSCLC patients when combined with RML.
目前缺乏关于非小细胞肺癌（NSCLC）患者淋巴结转移对生存影响的确切验证证据。我们旨在评估包括阴性淋巴结数量（NLN）在内的几种淋巴结转移相关危险因素的预后影响，并将NSCLC患者风险分层为具有不同预后的亚组。
本研究共纳入482例N1和N2期NSCLC患者。通过单因素和多因素分析检验一组危险因素的预后重要性。计算切点和5年生存率，以测试对患者进行分层的最佳分组系统，使其具有不同的预后结果。
我们的分析表明，转移淋巴结比例（RML）和阴性淋巴结数量（NLN）均与总生存期（OS）和无病生存期（DFS）相关。RML百分比20%和55%，以及NLN计数10和30被证明是通过将患者分为3组来预测OS的最佳切点。与女性患者相比，RML和NLN在预测男性患者生存结果方面实际上更具效力。使用联合因素的分层生存分析表明，RML I + NLN I/III亚组的5年生存率（5-YSR）较高（5-YSR = 57.1%和43.3%），而RML III + NLN II/III亚组的5年生存率较低（5-YSR均为0.0%）。
NLN是II/IIIa期NSCLC患者OS和DFS的强有力预后因素，与RML联合使用时可为NSCLC患者提供有用分类方案。
