cN+对于病理Ⅱ期结直肠癌患者检出淋巴结数目的影响及预后探讨:SEER数据库和中国医院数据的回顾性队列研究

Significance of cN+for the Number of Harvested Lymph Node and Prognosis of Pathological Stage Ⅱ Colorectal Cancer:A Retrospective Cohort Study from SEER Databases and Chinese Hospital Datasets

[目的]探讨cN+对于病理Ⅱ期结直肠癌患者检出淋巴结数目及预后的影响。[方法]收集2004—2015年美国SEER数据库23 565例及2011—2015年中国医学科学院肿瘤医院(Cancer Hospital Chinese Academy of Medical Sciences,CHCAMS)数据中454例病理Ⅱ期结直肠癌患者的临床基线资料。比较检出淋巴结数目<12枚和≥12枚两组患者基线资料差异。行Logistic回归分析明确cN+是否是影响检出淋巴结数目的因素。并分析cN+对于检出淋巴结数目≥12枚组患者5年总生存期(overall survival,OS)的影响。[结果]两个数据集中检出淋巴结数目≥12枚组较<12枚组cN+比例均更高(SEER:4%vs 2%,CHCAMS:52%vs 22%),且cN+均是检出淋巴结数目≥12枚的独立影响因素(SEER:OR=1.497,95%CI:1.133~1.979,P=0.005;CHCAMS:OR=2.698,95%CI:1.221~5.960,P=0.014)。两个数据集中,检出淋巴结数目≥12枚组患者中cN+组较cN_(0)组均具有更好的5年OS (SEER:80.6%vs 74.9%,HR=0.74,95%CI:0.58~0.95,P=0.016;CHCAMS:90.3%vs 83.2%,HR=0.53,95%CI:0.31~0.91,P=0.020)。[结论]cN+是检出淋巴结数目≥12枚的影响因素,且对于检出淋巴结数目≥12枚组病理Ⅱ期结直肠癌患者,cN+组具有更好的5年OS。

[Objective]To explore the significance of cN+for the number of harvested lymph nodes(LN)and prognosis of pathological stageⅡcolorectal cancer(CRC).[Methods]The clini-cal information of 23565 pathological stageⅡCRC patients from 2004 to 2015 in SEER databases and that of 454 pathological stageⅡCRC patients from 2011 to 2015 in Cancer Hospi-tal Chinese Academy of Medical Sciences(CHCAMS)were analyzed.The baseline characteristics between LN<12 and LN≥12 group were compared.And the Logistic regression analysis was con-ducted to investigate whether cN+was the influencing factor of the number of LN or not.The ef-fect of cN+on the 5-year overall survival(OS)of patients within LN≥12 group was analyzed.[Results]There were higher ratio of cN+in LN≥12 group than in LN<12 group in both datasets(SEER:4%vs 2%,CHCAMS:52%vs 22%).Positive clinical LN stage(cN+)was the signifi-cant independent factor for LN≥12(SEER:OR=1.497,95%CI:1.133~1.979,P=0.005;CHCAMS:OR=2.698,95%CI:1.221~5.960,P=0.014).The cN+group had a better 5-year OS than cN_(0) group in LN≥12 group(SEER:80.6%vs 74.9%,HR=0.74,95%CI:0.58~0.95,P=0.016;CHCAMS:90.3%vs 83.2%,HR=0.53,95%CI:0.31~0.91,P=0.020).[Conclusion]cN+is the influencing factor for LN≥12;and for pathological stageⅡCRC patients with LN≥12,cN+is associated with a better 5-year OS.