在睾丸生殖细胞肿瘤患者中，淋巴结比率而非阳性淋巴结计数具有更好的预后价值。

Lymph Node Ratio Rather Than Positive Lymph Node Counts Has Better Prognostic Value in Patients With Testicular Germ Cell Tumors.

机构信息

The Central Hospital of Shaoyang, Shaoyang, China.

Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.

出版信息

Technol Cancer Res Treat. 2021 Jan-Dec;20:1533033820979702. doi: 10.1177/1533033820979702.

DOI:10.1177/1533033820979702

PMID:33455540

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7816529/

Abstract

BACKGROUND

Testicular cancer represents the most common malignancy in young adult men. In the current study, we sought to analyze and compare the prognostic value of lymph node ratio (LNR) as well as positive lymph node counts (LNC) to understand its clinical significance in testicular germ cell tumors.

METHODS

We employed eligibility criteria to recruit a total of 931 patients, with testicular cancer, from 2010 to 2015 from The Surveillance, Epidemiology, and End Results (SEER) database. We then used the X-Tile program to calculate LNR and LNC cutoff values and discriminate survival. We then calculated the overall and cancer specific survival rates and analyzed the association between LNR/LNC and clinical pathological characteristics using the χ test. Finally, we assessed the relationships between clinical pathological factors and patient survival using univariate Cox proportional hazard analysis.

RESULTS

Univariate analysis revealed a significant association between prognosis with age (HR, 5.169; 95% CI, 1.758-15.200; = 0.003), AJCC stage (III vs I: HR, 9.298; 95% CI, 2.691-32.131; < 0.001), M stage (HR, 7.897; 95% CI, 3.417-18.251; < 0.001) and LNR (HR, 3.009; 95% CI, 1.275-7.098; = 0.012). On the other hand, LNC (HR, 1.743; 95% CI, 0.687-4.420; = 0.242) was not significantly associated with prognosis. Analysis of the association between LNR/LNC and clinical pathological characteristics showed that high LNR patients tended to have significantly larger tumor sizes (χ = 7.877, = 0.005), as well as advanced T (χ = 13.195, = 0.004), N ( χ = 86.775, < 0.001), M (χ = 19.948, < 0.001) and 7th AJCC (χ = 103.074, < 0.001) stages. In addition, high LNC patients were significantly associated with T (χ = 8.799, = 0.032), N (χ = 74.390, < 0.001) and 7th AJCC (χ = 111.759, < 0.001) stages.

CONCLUSION

LNR was a better predictor for long-term prognosis and was closely associated with clinical pathological characteristics than LNC in patients with testicular germ cell tumors.

摘要

背景

睾丸癌是青年男性最常见的恶性肿瘤。在本研究中，我们旨在分析和比较淋巴结比（LNR）和阳性淋巴结计数（LNC）的预后价值，以了解其在睾丸生殖细胞肿瘤中的临床意义。

方法

我们采用纳入标准，从 2010 年至 2015 年从监测、流行病学和最终结果（SEER）数据库中招募了 931 名睾丸癌患者。然后，我们使用 X-Tile 程序计算 LNR 和 LNC 截断值并区分生存情况。然后，我们计算了总生存率和癌症特异性生存率，并使用 χ 检验分析 LNR/LNC 与临床病理特征之间的关系。最后，我们使用单因素 Cox 比例风险分析评估临床病理因素与患者生存之间的关系。

结果

单因素分析显示，年龄（HR，5.169；95%CI，1.758-15.200； = 0.003）、AJCC 分期（III 期与 I 期：HR，9.298；95%CI，2.691-32.131；＜0.001）、M 期（HR，7.897；95%CI，3.417-18.251；＜0.001）和 LNR（HR，3.009；95%CI，1.275-7.098； = 0.012）与预后显著相关。另一方面，LNC（HR，1.743；95%CI，0.687-4.420； = 0.242）与预后无显著相关性。分析 LNR/LNC 与临床病理特征之间的关系表明，高 LNR 患者的肿瘤大小明显更大（ χ = 7.877， = 0.005），且 T 期（ χ = 13.195， = 0.004）、N 期（ χ = 86.775，＜0.001）、M 期（ χ = 19.948，＜0.001）和 7 期 AJCC 分期（ χ = 19.948，＜0.001）也更晚。此外，高 LNC 患者与 T 期（ χ = 8.799， = 0.032）、N 期（ χ = 74.390，＜0.001）和 7 期 AJCC 分期（ χ = 111.759，＜0.001）显著相关。