Kang Il Ku, Kim Kwangsoon, Park Joonseon, Bae Ja Seong, Kim Jeong Soo
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Cancers (Basel). 2022 Jul 28;14(15):3677. doi: 10.3390/cancers14153677.
The lymph node ratio (LNR) indicates the number of metastatic lymph nodes (LNs) to the total number of LNs. The prognostic value of LNR in papillary thyroid carcinoma (PTC) and other solid tumors is known. This study aimed to investigate the relationship between LNR and disease-free survival (DFS) in patients with PTC with lateral LN metastases (N1b PTC). A total of 307 patients with N1b PTC who underwent total thyroidectomy and therapeutic central and lateral LN dissection were retrospectively analyzed. The DFS and recurrence risk in the patients with LNR, central-compartment LNR (CLNR), and lateral-compartment LNR (LLNR) were compared. The mean follow-up duration was 93.6 ± 19.9 months. Eleven (3.6%) patients experienced recurrence. Neither LNR nor LLNR affected the recurrence rate in our analysis ( 0.058, 0.106, respectively). However, there was a significant difference in the recurrence rates between the patients with low and high CLNR (2.1% vs. 8.8%, 0.017). In the multivariate analysis, CLNR ≥ 0.7 and perineural invasion were independent predictors of tumor recurrence. High CLNR was associated with an increased risk of recurrence, and was shown to be a significant predictor of prognosis in patients with N1b PTC.
淋巴结比率（LNR）指转移淋巴结（LN）数量与总淋巴结数量之比。LNR在甲状腺乳头状癌（PTC）及其他实体瘤中的预后价值已为人所知。本研究旨在探讨LNR与伴有侧方淋巴结转移的PTC患者（N1b PTC）无病生存期（DFS）之间的关系。对307例行甲状腺全切除术及治疗性中央区和侧方淋巴结清扫术的N1b PTC患者进行回顾性分析。比较LNR、中央区淋巴结比率（CLNR）和侧方区淋巴结比率（LLNR）患者的DFS及复发风险。平均随访时间为93.6±19.9个月。11例（3.6%）患者出现复发。在我们的分析中，LNR和LLNR均未影响复发率（分别为0.058和0.106）。然而，CLNR低和高的患者之间复发率存在显著差异（2.1%对8.8%，P = 0.017）。在多因素分析中，CLNR≥0.7和神经侵犯是肿瘤复发的独立预测因素。高CLNR与复发风险增加相关，并且被证明是N1b PTC患者预后的重要预测因素。
