淋巴结转移度对进展期结直肠癌的预后作用

Effect of lymph node metastasis on prognosis of progressive colorectal cancer

目的探讨淋巴结转移度(lymph node ratio,LNR)对进展期结直肠癌的预后作用。方法对2007年1月-2012年1月在本院普通外科行根治手术的181例结直肠癌临床资料进行分析。结果根据LNR中位数将结直肠癌患者分为低LNR组(LNR<0.17,96例)和高LNR组(LNR≥0.17,85例),两组1年、3年、5年总生存率(overall survival,OS)分别为97.9%vs 87.1%、88.8%vs 61.0%、69.6%vs 43.9%,差异有统计学意义。多因素分析结果显示检出淋巴结数(examined lymph nodes,ELN)和LNR均为影响结直肠癌预后的独立相关因素,且ELN分层分析结果显示,LNR对进展期结直肠癌预后作用独立于ELN。结论 LNR具有独立预后作用,可作为进展期结直肠癌淋巴结分期和预后判断的重要补充。

Objective To study the effect of lymph node metastasis on prognosis of progressive colorectal cancer. Methods Clinical data about 181 colorectal cancer patients who underwent radical operation in our hospital from January 2007 to January 2012 were retrospectively analyzed. Results The patients were divided into low lymph node metastasis （ 〈 0.17） group （n=96） and high lymph node metastasis （≥0.17） group （n=85）, The I- and 5-year overall survival （OS） rates were higher and the 3-year OS rate was lower in low lymph node metastasis group than in high lymph node metastasis group （97.9% vs 87.1%, 88.8% vs 61.0%, 69.6% vs 43.9%, P 〈 0.05）. Multivariate regression analysis showed that the number of detected lymph nodes and lymph node metastasis were the independent factors for the prognosis of colorectal cancer. Stratification analysis revealed that the effect of lymph node metastasis on the prognosis of colorectal cancer was independent of the number of detected lymph nodes. Conclusion Lymph node metastasis is an independent factor for the prognosis of colorectal cancer, and can thus be used as an important supplement indication for staging colorectal cancer and judging its prognosis.