食管癌根治性切除术后阴性淋巴结的意义：一项回顾性队列研究
The Significance of Negative Lymph Nodes in Esophageal Cancer After Curative Resection: A Retrospective Cohort Study.
作者信息
Mo Junxian, Chen Dongni, Li Changbo, Chen Mingwu
机构信息
Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People's Republic of China.
Department of Cardio-Thoracic Surgery, The Seventh Affiliated Hospital of Guangxi Medical University, Wuzhou, Guangxi 543000, People's Republic of China.
出版信息
Cancer Manag Res. 2020 Feb 20;12:1269-1279. doi: 10.2147/CMAR.S232856. eCollection 2020.
OBJECTIVE
The impact of negative lymph nodes (NLNs) count on prognosis in esophageal cancer (EC) was analyzed using two institutions surgical database.
METHODS
We conducted a retrospective study of 768 EC patients treated by surgical resection between January 2010 and December 2012. The effects of the NLNs count on prognosis was analyzed. Cox regression model was conducted to determine the significant prognostic elements.
RESULTS
The number of NLNs was studied as a categorical variable based on the quartiles (Q1: ≤15, Q2: 16-21, Q3: 22-30, Q4: ≥31). And a better overall survival (OS) was observed with increasing number of NLNs (HR= 0.762; 95% CI, 0.596-0.974 for Q2, HR= 0.666; 95% CI, 0.516-0.860 for Q3 and HR= 0.588; 95% CI, 0.450-0.768 for Q4) (all <0.05). Multivariate regression analysis revealed that the NLNs count was an independent prognostic factor. Besides, for patients in T2 or T3 stage, a high number of NLNs was found to be significantly associated with a favorable OS (log rank <0.001).
CONCLUSION
A higher number of NLNs is independently related to the better OS in EC patients after surgical resection.
目的
利用两个机构的手术数据库分析阴性淋巴结（NLNs）数量对食管癌（EC）预后的影响。
方法
我们对2010年1月至2012年12月期间接受手术切除的768例EC患者进行了回顾性研究。分析了NLNs数量对预后的影响。采用Cox回归模型确定显著的预后因素。
结果
根据四分位数将NLNs数量作为分类变量进行研究（Q1：≤15，Q2：16 - 21，Q3：22 - 30，Q4：≥31）。随着NLNs数量增加，总生存期（OS）更佳（Q2的HR = 0.762；95%CI，0.596 - 0.974，Q3的HR = 0.666；95%CI，0.516 - 0.860，Q4的HR = 0.588；95%CI，0.450 - 0.768）（均<0.05）。多因素回归分析显示NLNs数量是独立的预后因素。此外，对于T2或T3期患者，发现大量NLNs与良好的OS显著相关（对数秩<0.001）。
结论
手术切除后，EC患者中较高数量的NLNs与较好的OS独立相关。
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