淋巴结转移度对Ⅲ期大肠癌患者发生远处转移的预测效果

Predictive Effect of Lymph Node Metastatic Ratio for Distant Metastasis in Stage ⅢColorectal Cancer

目的探讨淋巴结转移度(LNR)对Ⅲ期大肠癌患者发生远处转移的预测效果。方法将进行根治性切除手术的55例Ⅲ期大肠癌患者依据LNR分为2组:低LNR组(LNR<0.167)和高LNR组(LNR≥0.167);分析LNR与大肠癌术后出现远处转移的关系。结果低LNR组(29例,52.7%)中未发生远处转移的患者19例(65.5%),发生远处转移的患者10例(34.5%);高LNR组(26例,47.3%)中未发生远处转移的患者11例(42.3%),发生远处转移的患者15例(57.7%)。高LNR组较低LNR组的大肠癌患者更容易发生远处转移;在发生远处转移的患者中,肝转移有15例,肺转移有6例,骨及多脏器转移有4例。多因素分析结果表明LNR、肿瘤类型及分化程度均是影响大肠癌发生远处转移的独立相关因素(RR:1.999;CI%:1.101~4.092;P=0.029)。结论 LNR与大肠癌术后发生远处转移构成独立相关,可与肿瘤类型、分化程度等作为评估大肠癌术后发生远处转移的参考指标。

Objective To study the predictive effect of lymph nodes metastatic ratio(LNR) for distant metastasis in stageⅢ colorectal cancer.Methods 55 patients with stage Ⅲ colorectal cancer were divided into 2 groups based on LNR: low LNR group(LNR < 0.167),and high LNR group(LNR≥0.167); the relationship between LNR and distant metastasis in colorectal cancer were analyzed.Results In the low LNR group(29 cases,52.7%),19(65.5%) cases had no distant metastasis,10(34.5%) cases had distant metastasis.In the high LNR group(26 cases,47.3%),11(42.3%) cases had no distant metastasis,15(57.7%) cases had distant metastasis.The high LNR group was more likely to have distant metastasis of colorectal cancer than low LNR group.In patients with distant metastasis,liver metastasis were 15 cases,pulmonary metastasis were 6 cases,bone and multiple organs metastasis were 4 cases.Multi-factor analysis showed that the LNR,tumor type and differentiation were independent factors correlating to distant metastasis of colorectal cancer(RR: 1.999; CI% : 1.101 ~ 4.092; P = 0.029).Conclusion LNR is independently correlated with distant metastasis of colorectal cancer,and serves as an important predicative factor for estimating the prognosis of colorectal cancer with tumor type,degree of differentiation.