Department of radiotherapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Int J Med Sci. 2021 Feb 10;18(7):1721-1729. doi: 10.7150/ijms.53555. eCollection 2021.
Lymphovascular invasion (LVI) is correlated with unfavorable prognoses in several types of cancers. We aimed to identify the informative features associated with LVI and to determine its prognostic value in colorectal cancer (CRC) patients. We retrospectively analyzed 1,474 CRC patients admitted in Wuhan Union Hospital between 2013 and 2017 as the development cohort and 549 CRC patients from The Cancer Genome Atlas (TCGA) database as the validation cohort. Logistical and Cox regression analyses were conducted to determine the oncological and prognostic significance of LVI in CRC patients. A survival nomogram based on LVI status was established using the Wuhan Union cohort and validated using TCGA cohort. The LVI detection rates were 21.64% in the Wuhan Union cohort and 35.15% in TCGA cohort. LVI was closely correlated with advanced T stage, N stage, and TNM stage. LVI positivity was an independent biomarker for unfavorable overall survival (hazard ratio [HR]=2.25, 95% confidence interval [CI]=1.70-2.96, P<0.0001) and worse disease-free survival (HR=2.34, 95% CI=1.76-3.12, P<0.0001) in CRC patients. The survival nomogram incorporating LVI exhibited good predictive performance and reliability in the Wuhan Union cohort and TCGA cohort. LVI is a significant indicator of advanced stage and is remarkably correlated with worse prognosis in CRC patients. The survival nomogram incorporating LVI may assist clinicians to better strategize the therapeutic options for patients with CRC.
脉管侵犯(LVI)与多种癌症的不良预后相关。我们旨在确定与 LVI 相关的信息特征,并确定其在结直肠癌(CRC)患者中的预后价值。我们回顾性分析了 2013 年至 2017 年期间在武汉协和医院就诊的 1474 例 CRC 患者作为开发队列,以及来自癌症基因组图谱(TCGA)数据库的 549 例 CRC 患者作为验证队列。使用逻辑回归和 Cox 回归分析确定 LVI 在 CRC 患者中的肿瘤学和预后意义。使用武汉协和队列建立基于 LVI 状态的生存列线图,并使用 TCGA 队列进行验证。武汉协和队列的 LVI 检出率为 21.64%,TCGA 队列的 LVI 检出率为 35.15%。LVI 与较晚的 T 分期、N 分期和 TNM 分期密切相关。LVI 阳性是总生存期不良(风险比 [HR]=2.25,95%置信区间 [CI]=1.70-2.96,P<0.0001)和无病生存期更差(HR=2.34,95%CI=1.76-3.12,P<0.0001)的独立生物标志物。包含 LVI 的生存列线图在武汉协和队列和 TCGA 队列中均具有良好的预测性能和可靠性。LVI 是晚期的重要指标,与 CRC 患者的预后不良显著相关。包含 LVI 的生存列线图可能有助于临床医生为 CRC 患者制定更好的治疗方案。