淋巴结比率作为头颈部鳞状细胞癌患者生存的预后因素。
Lymph node ratio as a prognostic factor for survival in patients with head and neck squamous cell carcinoma.
作者信息
Sano Daisuke, Yabuki Kenichiro, Takahashi Hideaki, Arai Yasuhiro, Chiba Yoshihiro, Tanabe Teruhiko, Nishimura Goshi, Oridate Nobuhiko
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, School of Medicine, Yokohama, Japan.
Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, School of Medicine, Yokohama, Japan.
出版信息
Auris Nasus Larynx. 2018 Aug;45(4):846-853. doi: 10.1016/j.anl.2017.11.015. Epub 2017 Dec 2.
OBJECTIVE
The purpose of this study is to validate the concept of lymph node ratio (LNR) in head and neck squamous cell carcinoma (HNSCC).
METHODS
A total of 63 patients with HNSCC who underwent resection of the primary tumor combined with neck dissection in our institution were analyzed in this study. LNR was defined as the number of positive lymph nodes divided by the total number of lymph nodes excised. LNR was categorized into two groups (<0.068 and ≥0.068) according to the results of receiver-operating characteristic plots for determination of the cut-off value.
RESULTS
LNR≥0.068 was associated with poor overall survival (OS), progression-free survival (PFS) and locoregional recurrence-free survival (LRFS) after resection of the primary tumor combined with neck dissection in patients with HNSCC. Univariate and multivariate data analysis showed that LNR≥0.068 was an independent prognostic factor for OS, PFS and LRFS. Both pathological T stage status (pT3 or 4) and ≥3 positive LNs were also an independent prognostic factors for PFS in patients with HNSCC in our univariate and multivariate analysis.
CONCLUSION
These results suggested that LNR could be useful tools in identifying HNSCC patients with poor outcomes.
目的
本研究旨在验证头颈部鳞状细胞癌（HNSCC）中淋巴结比率（LNR）的概念。
方法
本研究分析了在我院接受原发肿瘤切除联合颈部清扫术的63例HNSCC患者。LNR定义为阳性淋巴结数量除以切除的淋巴结总数。根据用于确定临界值的受试者工作特征曲线结果，将LNR分为两组（<0.068和≥0.068）。
结果
在HNSCC患者中，LNR≥0.068与原发肿瘤切除联合颈部清扫术后的总生存期（OS）、无进展生存期（PFS）和无局部区域复发生存期（LRFS）较差相关。单因素和多因素数据分析表明，LNR≥0.068是OS、PFS和LRFS的独立预后因素。在我们的单因素和多因素分析中，病理T分期状态（pT3或4）和≥3个阳性淋巴结也是HNSCC患者PFS的独立预后因素。
结论
这些结果表明，LNR可能是识别预后不良的HNSCC患者的有用工具。
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