临床肿瘤学杂志

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阳性淋巴结比率对结直肠癌患者预后的预测价值

李庆刚1,钱文彪2,胡晓翠2,刘丹1   

  1. 1 哈尔滨医科大学附属第一医院感染科 2 哈尔滨医科大学附属第二医院消化内科
  • 收稿日期:2013-04-18 修回日期:2013-06-22 出版日期:2013-08-31 发布日期:2013-08-31
  • 通讯作者: 刘丹

Prognostic value of positive lymph node ratio in colorectal cancer

LI Qinggang, QIAN Wenbiao,HU Xiaocui,LIU Dan.   

  1. Department of Infectious Disease,the First Affiliated Hospital of Harbin Medical University
  • Received:2013-04-18 Revised:2013-06-22 Online:2013-08-31 Published:2013-08-31
  • Contact: : LIU Dan

摘要: 目的 探讨阳性淋巴结比率(LNR)对有淋巴结转移的结直肠癌患者3年生存率和3年无病生存率的预测价值。方法 收集2003年7月到2007年12月接受根治性手术的102例有淋巴结转移的散发性结直肠癌患者的临床病理资料。根据四分位法将患者按LNR值分为4组,分别为LNR1(LNR≤第25百分位数)、LNR2(第25百分位数<LNR≤第50百分位数)、LNR3(第50百分位数<LNR<第75百分位数)和LNR4(LNR≥第75百分位数)。用KaplanMeier法进行生存分析,用Cox比例风险回归模型进行生存多因素分析。
结果 102例Ⅲ、Ⅳ期结直肠癌患者的3年生存率为72.5%,3年无病生存率为61.8%。腺癌、低级别分化患者的3年生存率更高(P<0.05)。LNR1、LNR2、LNR3和LNR4 4组患者的3年生存率分别为100.0%、76.9%、68.0%和42.3%(P<0.001),3年无病生存率分别为92.0%、61.5%、68.0%和26.9%(P<0.001)。 Kaplan-Meier生存分析显示,LNR1+LNR2组的3年生存率和3年无病生存率显著高于LNR3+LNR4组(P<0.05)。Cox风险回归模型显示,LNR是结直肠癌患者预后的独立预测指标(P=0.036)。
结论LNR能够准确判断结直肠癌患者的预后。

Abstract: Objective To investigate the prognostic value of lymph node ratio(LNR) in predicting overall survival and diseasefree survival in colorectal cancer(CRC) patients with metatastic lymph nodes. Methods From July 2003 to December 2007, data from a total of 102 patients who underwent radical operation for CRC with lymph node metastases were analyzed. The patients were stratified into four groups according to LNR quartiles:LNR1(LNR≤Q1),LNR2(Q1<LNR≤Q2),LNR3(Q2<LNR<Q3) and LNR4(LNR≥Q3).KaplanMeier method was used to evaluate the survival. A Cox regression model was used for multivariate analyses. Results The 3-year overall survival rate and diseasefree survival rate were 72.5% and 61.8% in CRC patients with stage ⅢⅣ. The 3year overall survival rate in patients with adenocarcinoma and low grade differentiation was higher(P<0.05). The 3year overall survival rates of patients with LNR1, LNR2, LNR3 and LNR4 were 100.0%,76.9%,68.0% and 42.3%,respectively(P<0.001). The 3year disease-free survival rates of patients with LNR1, LNR2, LNR3 and LNR4 were 92.0%, 61.5%, 68.0% and 26.9%, respectively(P<0.001). Kaplan-Meier analysis showed that the prognosis in LNR1+LNR2 group was superior to LNR3+LNR4 group(P<0.05). Cox proportional hazards regression analysis revealed that LNR was an independent significant factor in predicting 3-year overall and diseasefree survival for CRC patients(P=0.036). Conclusion The LNR is a major independent prognostic factor for the CRC patients with node-positive.

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