Omeroglu Sinan, Gulmez Selcuk, Uzun Orhan, Senger Aziz Serkan, Bostanci Ozgur, Guven Onur, Polat Erdal, Duman Mustafa
Department of General Surgery, University of Health Sciences Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Türkiye.
Department of Gastrointestinal Surgery, University of Health Sciences Kosuyolu High Specialization Education and Research Hospital, Istanbul, Türkiye.
Front Oncol. 2023 Mar 6;13:1120753. doi: 10.3389/fonc.2023.1120753. eCollection 2023.
The metastatic lymph nodes (MLN) are interpreted to be correlated with prognosis of the colorectal cancers (CRC). The present retrospective study aimed to investigate the clinical significance of the largest MLN size in terms of postoperative outcomes and its predictive value in the prognosis of the patients with stage III CRC.
Between May 2013 and December 2018, a total of 101 patients who underwent curative resection for stage III CRC retrospectively reviewed. All patients were divided into two groups regarding cut-off value (<1.05 cm and ≥1.05 cm) of maximum MLN diameter measured histopathologically. A comparative analysis of demographic and clinicopathological characteristics of the patients and their postoperative outcomes were performed.
Two groups carried similar demographic data and preoperative laboratory variables except the lymphocyte count, hematocrit (HCT) ratio, hemoglobin level and mean corpuscular volume (MCV) value (p<0.05). The patients with MLN diameter ≥1.05 cm (n=46) needed more erythrocyte suspension and were hospitalized longer than the patients with a diameter <1.05 cm (n=55) (p=0.006 and 0.0294, respectively). Patients with MLN diameter < 1.05 cm had a significantly longer overall survival than patients with MLN diameter ≥ 1.05 cm (75,29 52,57 months, respectively). Regarding the histopathologic features, the patients with MLN diameter ≥1.05 cm had larger tumor size and higher number of MLN than those with diameter <1.05 cm (p=0.049 and 0.001).
The size of MLN larger than 1.05 cm may be predictive for a poor prognosis and lower survival of stage III CRC patients. The largest MLN size may be a proper alternative factor to the number of MLNs in predicting prognosis or in staging CRC patients.
转移性淋巴结（MLN）被认为与结直肠癌（CRC）的预后相关。本回顾性研究旨在探讨最大MLN大小对III期CRC患者术后结局的临床意义及其预后预测价值。
回顾性分析2013年5月至2018年12月期间共101例行III期CRC根治性切除术的患者。根据组织病理学测量的最大MLN直径的临界值（<1.05 cm和≥1.05 cm）将所有患者分为两组。对患者的人口统计学和临床病理特征及其术后结局进行比较分析。
除淋巴细胞计数、血细胞比容（HCT）比值、血红蛋白水平和平均红细胞体积（MCV）值外，两组的人口统计学数据和术前实验室变量相似（p<0.05）。MLN直径≥1.05 cm的患者（n = 46）比直径<1.05 cm的患者（n = 55）需要更多的红细胞悬液，住院时间更长（分别为p = 0.006和0.0294）。MLN直径<1.05 cm的患者总生存期明显长于MLN直径≥1.05 cm的患者（分别为75.29个月和52.57个月）。在组织病理学特征方面，MLN直径≥1.05 cm的患者肿瘤体积更大，MLN数量更多，高于直径<1.05 cm的患者（p = 0.049和0.001）。
MLN大小大于1.05 cm可能预示III期CRC患者预后不良和生存率较低。最大MLN大小可能是预测CRC患者预后或分期时MLN数量的一个合适替代因素。
