Tu Junhao, Yao Zongxi, Wu Wenqing, Ju Jianxiang, Xu Yinkai, Liu Yulin
Department of General Surgery, Suzhou Wuzhong People's Hospital, Suzhou, China.
Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
Front Oncol. 2021 Mar 30;11:663154. doi: 10.3389/fonc.2021.663154. eCollection 2021.
To validate the prognostic value and evaluate the predictive value of response to adjuvant chemotherapy of perineural invasion (PNI) in node-negative colon cancer using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) 18 tumor registry database.
Patients diagnosed with colon cancer from the SEER database between January 1, 2010 and December 31, 2015 were identified. Chi-square analysis was performed to evaluate different demographic and clinical features of patients between PNI-negative (PNI (-)) and PNI-positive (PNI (+)) groups. Univariate and multivariate Cox proportional hazard regression models were built to examine the relationship of demographic and clinical features and survival outcomes with the hazard ratios (HRs) and 95% confidence intervals (CIs).
In total, 57,255 node-negative colon cancer patients were extracted from the SEER database. The receipt of chemotherapy was not an independent prognostic factor for CSS in T3 colon cancer with or without the presence of PNI (P >0.05). The receipt of chemotherapy was independently associated with 34.0% decreased risk of cancer-specific mortality compared with those without the receipt of chemotherapy in T4 colon cancer without the presence of PNI (HR = 0.660, 95%CI = 0.559-0.779, P <0.001); the receipt of chemotherapy was independently associated with 36.0% decreased risk of cancer-specific mortality compared with those without the receipt of chemotherapy in T4 colon cancer with the presence of PNI (HR = 0.640, 95%CI = 0.438-0.935, P = 0.021).
The present study demonstrated the poor prognosis of PNI (+) in both stage I and II colon cancer. However, the presence of PNI was not a predictive factor of response to adjuvant chemotherapy in node-negative colon cancer.
利用美国国立癌症研究所的监测、流行病学和最终结果（SEER）18肿瘤登记数据库，验证神经周围侵犯（PNI）在无淋巴结转移结肠癌中的预后价值，并评估其对辅助化疗反应的预测价值。
确定2010年1月1日至2015年12月31日期间SEER数据库中诊断为结肠癌的患者。进行卡方分析以评估PNI阴性（PNI（-））组和PNI阳性（PNI（+））组患者的不同人口统计学和临床特征。构建单因素和多因素Cox比例风险回归模型，以检验人口统计学和临床特征以及生存结果与风险比（HR）和95%置信区间（CI）之间的关系。
共从SEER数据库中提取了57255例无淋巴结转移的结肠癌患者。在有或无PNI的T3结肠癌中，接受化疗不是CSS的独立预后因素（P>0.05）。在无PNI的T4结肠癌中，与未接受化疗的患者相比，接受化疗与癌症特异性死亡率风险降低34.0%独立相关（HR=0.660，95%CI=0.559-0.779，P<0.001）；在有PNI的T4结肠癌中，与未接受化疗的患者相比，接受化疗与癌症特异性死亡率风险降低36.0%独立相关（HR=0.640，95%CI=0.438-0.935，P=0.021）。
本研究表明，PNI（+）在I期和II期结肠癌中预后均较差。然而，PNI的存在不是无淋巴结转移结肠癌辅助化疗反应的预测因素。
