淋巴结比率在头颈部鳞癌中的预后能力。
Prognostic capacity of the lymph node ratio in squamous cell carcinomas of the head and neck.
机构信息
Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, España.
Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España.
出版信息
Acta Otorrinolaringol Esp (Engl Ed). 2020 Sep-Oct;71(5):265-274. doi: 10.1016/j.otorri.2020.04.001. Epub 2020 May 28.
INTRODUCTION AND OBJECTIVES
Lymph node density or lymph node ratio (LNR), defined as the quotient between the total number of positive lymph nodes and the total number of dissected lymph nodes, has demonstrated a prognostic capacity in several tumour models, including patients with head and neck squamous cell carcinomas (HNSCC). The aim of the present study is to analyse the prognostic value of LNR in a wide cohort of patients with HNSCC.
METHODS
We carried out a retrospective study of a cohort of 1,311 patients with HNSCC treated with unilateral or bilateral neck dissections. Of the patients included in the study, 55.0% had lymph node metastases (pN+). We proceeded to calculate the value of the LNR, and its categorization through a recursive partition analysis considering specific survival as the dependent variable.
RESULTS
Three categories were defined according to the value of the LNR with a cut-off point at the values < of .025 and .118. The 5-year specific survival for patients with an LNR less than .025 (n=654, 49.8%) was 87.2%, for patients with a LNR .025-.118 (n=394, 30.1%) it was 51.6%, and for patients with a LNR greater than .188 (n=263, 20.1%) it was 27.3% (P=.0001). According to the results of a multivariate analysis, the LNR significantly related to specific survival.
CONCLUSION
The LNR can be a prognostic variable to be considered in the pathological staging of the lymph nodes.
介绍和目的
淋巴结密度或淋巴结比率（LNR）定义为阳性淋巴结总数与切除淋巴结总数的商，已在包括头颈部鳞状细胞癌（HNSCC）患者在内的多种肿瘤模型中显示出预后能力。本研究的目的是分析 LNR 在广泛的 HNSCC 患者队列中的预后价值。
方法
我们对 1311 例接受单侧或双侧颈部清扫术治疗的 HNSCC 患者进行了回顾性研究。研究中包括的患者中有 55.0%有淋巴结转移（pN+）。我们计算了 LNR 的值，并通过递归分区分析考虑特定生存作为因变量对其进行分类。
结果
根据 LNR 的值定义了三个类别，截断值为<0.025 和 0.118。LNR 小于 0.025（n=654，49.8%）的患者 5 年特异性生存率为 87.2%，LNR 为 0.025-0.118（n=394，30.1%）的患者为 51.6%，LNR 大于 0.188（n=263，20.1%）的患者为 27.3%（P=0.0001）。根据多变量分析的结果，LNR 与特定生存显著相关。
结论
LNR 可以作为淋巴结病理分期中需要考虑的预后变量。
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