Lee Yoon Hee, Chong Gun Oh, Kim Su Jeong, Hwang Ja Hyun, Kim Jong Mi, Park Nora Jee-Young, Hong Dae Gy
Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
Cancer Manag Res. 2021 Oct 28;13:8137-8145. doi: 10.2147/CMAR.S332612. eCollection 2021.
This study evaluated the prognostic value of various lymph node (LN) characteristics, including the lymph node ratio (LNR), in patients with cervical cancer treated with radical hysterectomy.
In this retrospective study, 260 patients with cervical cancer who had undergone radical hysterectomy with pelvic or paraaortic lymphadenectomies were included. LN characteristics related to several LN statuses included total LN counts, LN metastasis, total positive LN counts, LNR, and levels of lymphadenectomy. LNR was defined as the number of metastatic LNs divided by the total number of LNs harvested. Univariate and multivariate analyses for disease-free survival (DFS) and overall survival (OS) were performed using the clinicopathological and LN characteristics.
Based on receiver-operating characteristics curve analysis, the cut-off value of LNR was 0.0625. Multivariate analysis revealed that high LNR was significantly related to tumor recurrence (hazard ratio [HR], 5.182; 95% confidence interval [CI], 2.424-11.075; < 0.0001). After adjusting for clinicopathological factors, LNR was also independent prognostic factor for predicting tumor recurrence (HR, 5.930; 95% CI, 2.114-16.634; = 0.0007). However, total retrieved LN counts and level of lymphadenectomy were not associated with survival outcomes.
LNR may be a prognostic biomarker for predicting disease recurrence in cervical cancer treated with radical hysterectomy.
本研究评估了包括淋巴结比率（LNR）在内的各种淋巴结（LN）特征对接受根治性子宫切除术的宫颈癌患者的预后价值。
在这项回顾性研究中，纳入了260例行根治性子宫切除术并伴有盆腔或腹主动脉旁淋巴结清扫术的宫颈癌患者。与几种LN状态相关的LN特征包括总LN计数、LN转移、总阳性LN计数、LNR和淋巴结清扫水平。LNR定义为转移LN的数量除以收获的LN总数。使用临床病理和LN特征对无病生存期（DFS）和总生存期（OS）进行单因素和多因素分析。
基于受试者工作特征曲线分析，LNR的临界值为0.0625。多因素分析显示，高LNR与肿瘤复发显著相关（风险比[HR]，5.182；95%置信区间[CI]，2.424 - 11.075；<0.0001）。在调整临床病理因素后，LNR也是预测肿瘤复发的独立预后因素（HR，5.930；95% CI，2.114 - 16.634；=0.0007）。然而，总回收LN计数和淋巴结清扫水平与生存结果无关。
LNR可能是预测接受根治性子宫切除术的宫颈癌疾病复发的预后生物标志物。
