Pyo Jung-Soo, Shin Young-Min, Kang Dong-Wook
Department of Pathology, Eulji University Hospital, Eulji University School of Medicine, Daejeon 35233, Korea.
Eulji University School of Medicine, Daejeon 34824, Korea.
J Clin Med. 2019 Nov 1;8(11):1812. doi: 10.3390/jcm8111812.
The proportion of the number of involved lymph nodes (LNs) to the number of examined LNs-defined as metastatic LN ratio (mLNR)-has been considered as a prognostic parameter. This study aims to elucidate the prognostic implication of the mLNR in colorectal cancer (CRC) according to the tumor location.
We evaluated the correlation between prognoses and the involved and examined LNs as well as mLNR according to the tumor location in 266 surgically resected human CRCs. Besides, to evaluate the optimal cutoff for high and low mLNRs, we investigated the correlation between mLNR and survival according to the various cutoffs.
LN metastasis was found in 146 cases (54.9%), and colon and rectal cancers were found in 116 (79.5%) and 30 (20.5%) of the cases, respectively. The mean mLNRs were significantly higher in rectal cancer than in colon cancer (0.38 ± 0.28 vs. 0.21 ± 0.24, = 0.003). Besides this, the number of involved LNs in rectal cancer was significantly high compared to colon cancer (11.83 ± 10.92 vs. 6.37 ± 7.78, = 0.014). However, there was no significant difference in the examined LNs between the rectal and colon cancers (31.90 ± 12.28 vs. 36.60 ± 18.11, = 0.181). In colon cancer, a high mLNR was significantly correlated with worse survival for all cutoffs (0.1, 0.2, 0.3, and 0.4). However, rectal cancer only showed a significant correlation between high mLNR and worse survival in the subgroup with a cutoff of 0.2.
Our results showed that high mLNR was significantly correlated with worse survival. The number of involved LNs and mLNRs were significantly higher in rectal cancer than in colon cancer. The cutoff of 0.2 can be useful for the differentiation of prognostic groups, regardless of tumor location.
受累淋巴结数量与检查淋巴结数量的比例（定义为转移淋巴结比率，mLNR）被视为一个预后参数。本研究旨在根据肿瘤位置阐明mLNR在结直肠癌（CRC）中的预后意义。
我们评估了266例接受手术切除的人类CRC患者的预后与受累及检查淋巴结以及mLNR之间的相关性，并根据肿瘤位置进行分析。此外，为了评估高、低mLNR的最佳临界值，我们研究了不同临界值下mLNR与生存率之间的相关性。
146例（54.9%）发现有淋巴结转移，其中结肠癌116例（79.5%），直肠癌30例（20.5%）。直肠癌的平均mLNR显著高于结肠癌（0.38±0.28对0.21±0.24，P = 0.003）。除此之外，直肠癌受累淋巴结数量显著高于结肠癌（11.83±10.92对6.37±7.78，P = 0.014）。然而，直肠癌和结肠癌检查的淋巴结数量无显著差异（31.90±12.28对36.60±18.11，P = 0.181）。在结肠癌中，所有临界值（0.1、0.2、0.3和0.4）下高mLNR均与较差的生存率显著相关。然而，直肠癌仅在临界值为0.2的亚组中显示高mLNR与较差的生存率显著相关。
我们的结果表明，高mLNR与较差的生存率显著相关。直肠癌受累淋巴结数量和mLNR显著高于结肠癌。临界值0.2可用于区分预后组，而不受肿瘤位置的影响。
