Department of Colorectal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Am J Clin Oncol. 2023 Aug 1;46(8):366-373. doi: 10.1097/COC.0000000000001015. Epub 2023 May 23.
Lymphovascular invasion (LVI) is a micropathological tumor factor believed to increase the risk of tumor metastasis and spread. Propensity score matching (PSM) is a statistical method that can control confounding factors. Current research rarely considers the confounding relationship between LVI and other factors that may influence prognosis. This study aimed to investigate the relationship between LVI and prognosis in patients with stage I-III colorectal cancer (CRC) by using propensity score matching (PSM).
This was a retrospective study involving 610 patients. PSM was used to adjust for baseline differences between the groups. The survival rates were calculated. A nomogram was constructed based on the Cox proportional hazards model before matching. The C-index, receiver operating characteristic curve (ROC), and calibration curve were used to evaluate the nomogram.
A total of 150 patients tested positive for LVI, accounting for 24.6% of the total, and 120 couples of patients were identified after PSM. The survival curve and Cox proportional hazards model after matching confirmed the adverse effects of LVI on tumor prognosis. The Cox proportional hazards model before matching showed that age, carcinoembryonic antigen level, T stage, N stage, histologic grade and LVI were independent prognostic factors. The C-index of the nomogram established based on the Cox proportional hazards model was 0.787 (95% CI=0.728-0.845). The areas under the curve were 0.796 in the 3-year ROC.
LVI is an adverse prognostic factor in patients with stage I-III colorectal cancer.
淋巴管浸润（LVI）是一种被认为会增加肿瘤转移和扩散风险的微观肿瘤因素。倾向评分匹配（PSM）是一种可以控制混杂因素的统计方法。目前的研究很少考虑 LVI 与其他可能影响预后的因素之间的混杂关系。本研究旨在通过使用倾向评分匹配（PSM）来研究 LVI 与 I-III 期结直肠癌（CRC）患者预后之间的关系。
这是一项回顾性研究，涉及 610 名患者。使用 PSM 来调整组间的基线差异。计算生存率。在匹配之前，基于 Cox 比例风险模型构建了一个列线图。使用 C 指数、接受者操作特征曲线（ROC）和校准曲线来评估列线图。
共有 150 名患者的 LVI 检测呈阳性，占总数的 24.6%，匹配后确定了 120 对患者。匹配后的生存曲线和 Cox 比例风险模型证实了 LVI 对肿瘤预后的不良影响。匹配前的 Cox 比例风险模型显示，年龄、癌胚抗原水平、T 分期、N 分期、组织学分级和 LVI 是独立的预后因素。基于 Cox 比例风险模型建立的列线图的 C 指数为 0.787（95%CI=0.728-0.845）。3 年 ROC 的曲线下面积为 0.796。
LVI 是 I-III 期结直肠癌患者的不良预后因素。
