Duan Wanyao, Wang Wei, He Chiyi
Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China.
Front Oncol. 2023 Apr 4;13:995637. doi: 10.3389/fonc.2023.995637. eCollection 2023.
The purpose of this study is to investigate the predictive significance of (platelet × albumin)/lymphocyte ratio (PALR) for lymph node metastasis (LNM) in patients with clinically node-negative colon cancer (cN0 CC).
Data from 800 patients with primary CC who underwent radical surgery between March 2016 and June 2021 were reviewed. The non-linear relationship between PALR and the risk of LNM was explored using a restricted cubic spline (RCS) function while a receiver operating characteristic (ROC) curve was developed to determine the predictive value of PALR. Patients were categorized into high- and low-PALR cohorts according to the optimum cut-off values derived from Youden's index. Univariate and multivariate logistic regression analyses were used to identify the independent indicators of LNM. Sensitivity analysis was performed to repeat the main analyses with the quartile of PALR.
A total of eligible 269 patients with primary cN0 CC were retrospectively selected. The value of the area under the ROC curve for PALR for predicting LNM was 0.607. RCS visualized the uptrend linear relationship between PALR and the risk of LNM (p-value for non-linearity > 0.05). PALR (odds ratio = 2.118, 95% confidence interval, 1.182-3.786, p = 0.011) was identified as an independent predictor of LNM in patients with cN0 CC. A nomogram incorporating PALR and other independent predictors was constructed with an internally validated concordance index of 0.637. The results of calibration plots and decision curve analysis supported a good performance ability and the sensitivity analysis further confirmed the robustness of our findings.
PALR has promising clinical applications for predicting LNM in patients with cN0 CC.
本研究旨在探讨（血小板×白蛋白）/淋巴细胞比值（PALR）对临床淋巴结阴性结肠癌（cN0 CC）患者淋巴结转移（LNM）的预测意义。
回顾性分析2016年3月至2021年6月期间接受根治性手术的800例原发性结肠癌患者的数据。使用受限立方样条（RCS）函数探索PALR与LNM风险之间的非线性关系，同时绘制受试者工作特征（ROC）曲线以确定PALR的预测价值。根据约登指数得出的最佳临界值，将患者分为高PALR组和低PALR组。采用单因素和多因素逻辑回归分析确定LNM的独立指标。进行敏感性分析，以PALR的四分位数重复主要分析。
共回顾性纳入269例符合条件的原发性cN0 CC患者。PALR预测LNM的ROC曲线下面积值为0.607。RCS显示PALR与LNM风险之间呈上升线性关系（非线性p值>0.05）。PALR（比值比=2.118，95%置信区间，1.182 - 3.786，p = 0.011）被确定为cN0 CC患者LNM的独立预测因子。构建了包含PALR和其他独立预测因子的列线图，内部验证一致性指数为0.637。校准图和决策曲线分析结果支持其良好的性能，敏感性分析进一步证实了我们研究结果的稳健性。
PALR在预测cN0 CC患者LNM方面具有良好的临床应用前景。
