阳性淋巴结对数比在胸段食管鳞癌患者长期预后中的预测作用

Role of Log Odds of Positive Lymph Nodes in Predicting Long-term Prognosis of Patients with Thoracic Esophageal Squamous Cell Carcinoma

目的评价阳性淋巴结对数比(LODDS)在预测不同胸段食管鳞癌患者长期预后中的作用。方法回顾性分析731例食管鳞癌根治术后患者临床资料,分析LODDS在全组患者、术后淋巴结阴性患者和术中清扫淋巴结数目<12枚患者中预测预后的价值。结果LODDS与阳性淋巴结个数和术中淋巴结清扫数目均显著相关(r=0.696、-0.530,均P=0.000)。ROC曲线分析结果显示LODDS最佳截点值为-1.028。多因素分析结果显示患者性别、年龄、食管病变部位、pT分期、阳性淋巴结个数和LODDS值为全组患者生存和术中淋巴结清扫数目≥12枚患者OS的独立影响因素(P<0.05);患者性别、年龄、食管病变部位、pT分期和LODDS值为术后淋巴结阴性患者生存的独立影响因素(P<0.05),而pT分期和LODDS值为术中淋巴结清扫数目<12枚患者OS的独立影响因素(P<0.05)。结论LODDS可以作为不同胸段食管鳞癌根治术后患者的独立性预后指标。

Objective To evaluate the role of the log odds of positive lymph nodes(LODDS)in predicting the long-term prognosis of patients with thoracic esophageal squamous cell carcinoma(TESCC).Methods We retrospectively analyzed the clinical data of 731 TESCC patients after radical surgery and the prognostic value of LODDS in the whole group of patients,postoperative lymph node-negative(pN0)patients and patients with the number of intraoperative lymph nodes dissected<12.Results LODDS was significantly correlated with the number of positive lymph nodes and the number of intraoperative lymph nodes dissected(r=0.696,-0.530,all P=0.000).ROC curve analysis showed that the optimal cut-off point of LODDS was-1.028.Multivariate analysis showed that gender,age,location of esophageal lesions,pT stage,number of positive lymph nodes and LODDS value were independent factors for the survival of the whole group and the OS of the patients with the number of intraoperative lymph nodes dissected≥12(P<0.05).Gender,age,location of esophageal lesions,pT stage and LODDS value were independent factors affecting the survival of pN0 patients after operation(P<0.05).pT stage and LODDS value were independent factors affecting the OS of the patients with the number of intraoperative lymph nodes dissected<12(P<0.05).Conclusion LODDS could be used as an independent prognostic index for the patients with different TESCC after radical surgery.