基于淋巴结比率的阑尾癌切除患者预后预测:一项SEER分析  

The prognostic prediction based on lymph node ratio for patients with resectedappendicealcarcinomas:a SEER analysis

作　　者：赵楠 王慧 徐亚东 ZHAO Nan;WANG Hui;XU Yadong(Department of General Surgery,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai,201700,China;Department of Infectious Disease,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai,201700,China)

机构地区：[1]复旦大学附属中山医院青浦分院普通外科,上海201700 [2]复旦大学附属中山医院青浦分院传染病科,上海201700

出　　处：《当代医学》2024年第7期15-19,共5页Contemporary Medicine

摘　　要：目的探讨淋巴结比率(LNR)在预测阑尾癌切除患者预后中的意义。方法选取2014至2018年阑尾癌监测、流行病学和最终结果(SEER)数据库中1232例阑尾癌确诊患者作为研究对象,收集患者年龄、性别、病理分级、T分类、N分类、M分类、TNM分期、区域淋巴结转移情况。统计阑尾癌患者的临床病理信息;分析LNR与临床特征的关系;通过Kaplan-Meier曲线分析总生存率(OS)和肿瘤特异性生存率(CCS)及其降低的危险因素。结果392例(31.82%)患者淋巴结转移。总生存期为0~59个月,中位生存期21.5个月。LNR≥0.0481和LNR<0.0481患者的年龄、病理分级、肝转移和T、N、M分类及TNM分期比较差异有统计学意义(P<0.05)。Kaplan-Meier曲线分析显示,LNR≥0.0481、年龄≥60岁患者OS和CSS均低于LNR<0.0481、年龄<60岁患者,差异有统计学意义(P<0.05)。Cox比例风险回归模型单因素分析结果显示,LNR≥0.0481、年龄≥60岁、病理分级、T分类、N分类和TNM分期较差、发生肝或肺或骨转移与OS、CSS降低相关(P<0.05)。多因素分析结果显示,年龄≥60岁、T分类高、TNM分期较差、发生肺或骨转移是OS、CSS降低的独立危险因素(P<0.05)。结论LNR≥0.0481和其他临床信息、年龄≥60岁、T分类高、TNM分期是阑尾癌的独立预测因子,LNR在临床上的真正意义和进一步意义有待进一步深入研究。Objective To investigate the significance of lymph node ratio(LNR)in predicting the prognosis of patients with appendectomy.Methods 1232 patients with confirmed appendiceal cancer were collected from the surveillance,epidemiology,and end results(SEER)database from 2014 to 2018.Age,sex,pathological grade,T classification,N classification,M classification,TNM stage,regional lymph node metastasis were collected as the research subjects,the clinicopathological information of patients with appendiceal cancer,and relationship between LNR and clinical features was analyzed.Kaplan-Meier curves were used to analyze overall survival(OS)and cancer-specific survival(CCS)and their reduced risk factors.Results Lymph node metastasis was found in 392 patients(31.82%).Overall survival ranged from 0 to 59 months,with a median of survival ranged 21.5 months.There were significant differences in age,pathological grade,liver metastasis,T,N,M classification and TNM stage between LNR≥0.0481 and LNR<0.0481 patients.Kaplan-Meier curve analysis showed that the OS and CSS of patients with LNR≥0.0481 and age≥60 years old lower than patients with LNR<0.0481 and age<60 years old,the differences were statistically significant(P<0.05).In Cox proportional risk regression model,univariate analysis showed that LNR≥0.0481,age≥60 years old,pathological grade,T classification,N classifi-cation,TNM stage,liver,lung,bone metastasis were related to decreased OS and CSS(P<0.05);the results of multifactor analysis showed that age≥60 years,T classification high,poor TNM stage,lung,bone metastasis were independent risk factors for decreased OS and CSS(P<0.05).Conclusion LNR≥0.0481 and other clinical information,age≥60 years old,T classification high,TNM stage,were independent predictors of CSS in appendiceal carcinoma,and the true and further meaning of LNR in clinic should be in-depth study in further.

关 键 词：阑尾癌 淋巴结比率 预后 

分 类 号：R735.36[医药卫生—肿瘤]