淋巴结转移度及肿瘤N分期对Ⅲ期结直肠癌复发或转移的预测价值  

Prognostic value of lymph node ratio and N stage in stage colorectal cancer

作　　者：任镜清[1] 薛福龙[1] 刘少杰[1] 刘建伟[1] 雷朝晖[1] 

机构地区：[1]广州市红十字会医院普通外科,510220

出　　处：《中华胃肠外科杂志》2015年第6期553-557,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：广东省科技计划项目（20128061700013）

摘　　要：目的：比较淋巴结转移度（LNR）及N分期对Ⅲ期结直肠癌复发或转移的预测价值。方法回顾性分析1998年1月至2011年12月广州市红十字会医院收治的304例Ⅲ期结直肠癌患者的临床病理资料。分别将LNR和N分期代入包含可能影响患者复发或转移的临床病理特征的Cox回归模型，比较两者的风险比（HR）；再根据送检淋巴结数目是否达到13枚／例进行分层分析。结果 LNR 及 N 分期均为Ⅲ期结直肠癌患者复发或转移的独立预测因素，LNR （HR＝1．838，95％ CI：1．563～2．161）的预测价值高于N分期（HR＝1．625，95％ CI：1．392～1．898）。亚组分析显示，当送检淋巴结数目大于或等于13枚／例时，LNR与N分期的预测价值相当（HR分别为1．876和1．853）；但当送检淋巴结数目少于13枚／例，LNR的预测价值高于N分期（HR分别为1．836和1．639）。结论 LNR分期对Ⅲ期结直肠癌患者复发或转移的预测价值优于N分期，尤其是对于送检淋巴结数目不足13枚者。Objective To compare the prognostic value of lymph node ratio and N staging in stage Ⅲ colorectal cancer. Methods The clinicopathologic factors and follow-up data of 304 cases with stage Ⅲ colorectal cancer from January 1998 to December 2011 were analyzed retrospectively. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Patients were divided into different subgroups according to the number of lymph nodes sample. Results LNR and N stage were independent risk factors for stage Ⅲ colorectal cancer, the prognostic value of LNR was better than that of N stage [Odds ratio were 1.838（95% CI：1.563~2.161） vs. 1.625 （95% CI：1.392~1.898）]. Subgroup analysis showed that, when the number of lymph nodes sample was less than 13, the prognostic value of LNR was better than that of N stage （Odds ratio were 1.836 vs. 1.639）. But when the number of lymph nodes sample was more than 13, they were comparable（Odds ratio were 1.876 vs. 1.853）. Conclusions The prognostic value of LNR and N stage were comparable for stage Ⅲ colorectal cancer, but when the number of lymph nodes sample was less than 13, LNR was more valuable.

关 键 词：结直肠肿瘤 淋巴结转移度 N分期 复发 转移 

分 类 号：R735.34[医药卫生—肿瘤]