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[淋巴结转移相关指标与N2b期结直肠癌患者预后的相关性]

[The association of metastasis-related indexes of lymph nodes and the prognosis of stage N2b colorectal cancer patients].

作者信息

Zheng W, Zhang L, Wu Y L, Zhang H Z

机构信息

Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2018 Sep 23;40(9):679-683. doi: 10.3760/cma.j.issn.0253-3766.2018.09.008.

Abstract

To evaluate the prognostic value of lymph node metastasis-related indexes in patients with stage N2b colorectal cancer. Clinicopathologic data of 245 patients with stage N2b colorectal cancer who initially underwent radical operation in Cancer Hospital, Chinese Academy of Medical Sciences between January 2007 and December 2012 were retrospectively analyzed. The prognostic values of several indexes, including number of positive lymph nodes, number of negative lymph nodes, lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) were analyzed. The 5-year overall survival rate of 245 patients with colorectal cancer was 54.0%, and the 5-year recurrence-free survival rate was 48.5%.Univariate analysis showed that perineural or blood vessel invasion, T stage, postoperative adjuvant therapy, number of positive lymph nodes, number of negative lymph nodes, LNR, and LODDS were significantly associated with the 5-year overall survival of colorectal cancer patients (<0.05). Multivariate cox regression analysis showed that, number of positive lymph nodes, number of negative lymph nodes, LNR, LODDS were all independent prognostic factors for stage N2b colorectal cancer patients (<0.05). The areas under the receiver operating characteristic curve (ROC) curves of number of positive lymph node, number of negative lymph nodes, LNR and LODDS were 0.649, 0.667, 0.690 and 0.683, respectively, however, no statistical significance was observed between the number of negative lymph nodes (=0.622), LNR (=0.178) or LODDS (=0.272) and the number of positive lymph nodes. The number of positive lymph nodes, number of negative lymph nodes, LNR and LODDS were all independent prognostic factors for patients with stage N2b colorectal cancer.

摘要

评估N2b期结直肠癌患者淋巴结转移相关指标的预后价值。回顾性分析2007年1月至2012年12月在中国医学科学院肿瘤医院首次接受根治性手术的245例N2b期结直肠癌患者的临床病理资料。分析了多个指标的预后价值,包括阳性淋巴结数目、阴性淋巴结数目、淋巴结比率(LNR)和阳性淋巴结对数比值(LODDS)。245例结直肠癌患者的5年总生存率为54.0%,5年无复发生存率为48.5%。单因素分析显示,神经或血管侵犯、T分期、术后辅助治疗、阳性淋巴结数目、阴性淋巴结数目、LNR和LODDS与结直肠癌患者的5年总生存率显著相关(<0.05)。多因素cox回归分析显示,阳性淋巴结数目、阴性淋巴结数目、LNR、LODDS均为N2b期结直肠癌患者的独立预后因素(<0.05)。阳性淋巴结数目、阴性淋巴结数目、LNR和LODDS的受试者工作特征曲线(ROC)下面积分别为0.649、0.667、0.690和0.683,然而,阴性淋巴结数目(=0.622)、LNR(=0.178)或LODDS(=0.272)与阳性淋巴结数目之间未观察到统计学差异。阳性淋巴结数目、阴性淋巴结数目、LNR和LODDS均为N2b期结直肠癌患者的独立预后因素。

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