淋巴结阳性比率对于肝内胆管癌患者预后的价值

Value of lymph node ratio in prognosis of patients with intrahepatic cholangiocarcinoma

目的评估淋巴结阳性比率(LNR)在判断肝内胆管癌(ICC)患者预后中的价值。方法从SEER数据库提取肝内胆管癌患者的临床病理及生存资料,应用Kaplan-Meier法和Cox比例危险模型探讨LNR在肝内胆管癌患者预后中的价值。结果本研究共纳入357例经病理证实的ICC患者。其中男性158例,女性199例。分析显示,有淋巴结转移患者的生存时间明显低于没有转移的患者[(41.6±1.8比(23.2±2.2)个月,P<0.05]。单因素分析显示,淋巴结转移显著增加患者死亡风险(HR=3.1,95%CI:2.1~4.4,P<0.05)。多因素生存分析表明,在校正了年龄、性别、肿瘤分期后,淋巴结转移状态与患者生存时间无关。仅有LNR≥20%是影响患者预后的独立危险因素(LNR≥20%比LNR<20%,HR:2.3,95%CI:1.4~3.8,P<0.05)。结论淋巴结阳性比率在判断肝内胆管癌患者生存方面的价值优于淋巴结转移状态。

Objective To determine the value of lymph node ratio(LNR)in prognosis of patients with intrahepatic cholangiocarcinoma(ICC).Methods The pathological and survival data of ICC patients were extracted from the Surveillance Epidemiology and End Result Database(SEER).The value of LNR in prognosis of patients with intrahepatic cholangiocarcinoma was evaluated by the Kaplan-Meier and Cox proportional hazard models.Results A total of 357 pathologically confirmed ICC patients were included in this study(158 males,199 females).The results showed that patients with lymph node metastasis had significantly shorter survival time than patients without metastasis[(41.6±1.8)vs.(23.2±2.2)months,P<0.05].Multivariate analysis on survival showed that the status of lymph node metastasis was independent prognostic factor of survival,after adjusting for age,gender and tumor stage.Only a LNR≥20% was an independent risk factor of prognosis(HR=2.3,95% CI:1.4~3.8,P<0.05).Conclusion A positive lymph node ratio was superior to lymph node metastasis in predicting survival in patients with intrahepatic cholangiocarcinoma.