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淋巴结转移度对食管癌患者预后的影响[J]. 肿瘤防治研究, 2010, 37(07): 790-794. DOI: 10.3971/j.issn.1000-8578.2010.07.015
引用本文: 淋巴结转移度对食管癌患者预后的影响[J]. 肿瘤防治研究, 2010, 37(07): 790-794. DOI: 10.3971/j.issn.1000-8578.2010.07.015
Impact of Lymph Node Ratio on Prognosis of Patients with Esophageal Cancer[J]. Cancer Research on Prevention and Treatment, 2010, 37(07): 790-794. DOI: 10.3971/j.issn.1000-8578.2010.07.015
Citation: Impact of Lymph Node Ratio on Prognosis of Patients with Esophageal Cancer[J]. Cancer Research on Prevention and Treatment, 2010, 37(07): 790-794. DOI: 10.3971/j.issn.1000-8578.2010.07.015

淋巴结转移度对食管癌患者预后的影响

Impact of Lymph Node Ratio on Prognosis of Patients with Esophageal Cancer

  • 摘要: 目的:探讨食管癌患者标准淋巴结清扫术后淋巴结转移度对预后的影响。方法:回顾性分析食管癌患者临床病理因素和随访资料,通过Kaplan-Meier曲线和Cox多因素回归模型分析来评估这些因素与生存期的关系。结果:245例手术患者共切除淋巴结1 758个,病理学报告112例患者共有220个淋巴结发生转移,总体转移率为45.71%,淋巴结转移度为0.13。单因素分析结果显示肿瘤残留状态、淋巴结状态和淋巴结转移度对患者5年生存率差异存在统计学意义(P<0.05)。在排除混杂因素的影响后,Cox多因素回归分析显示组织学类型、肿瘤残留状态、浸润深度、淋巴结状态和淋巴结转移度均可作为影响患者预后的独立危险因素(P<0.05)。结论:食管癌手术采用标准的淋巴结清扫术,淋巴结转移的个数不能明确影响pN1患者的预后,而淋巴结转移度对患者的预后有较强的敏感度,具有一定的参考价值。

     

    Abstract: Objective:To assess the impact of lymph node ratio (LNR) on prognosis for esophageal cancer (EC) patients undergoing standard lymphadenectomy. Methods :Data including demographic, clinicopathological factors and prognostic outcome of EC patients were collected retrospectively.Kaplan-Meier curves and Cox regression analysis were used to evaluate the association between survival and these factors. Results :Of 1758 LNs yielded from 245 cases, 220 LNs were identified positive from 112 pN1 patients by pathological examination.So LN metastasis rate was 45.71% and LNR was 0.13 to the total cohort.There was a statistically significant benefit in the 5-year survival rate for patients with more radical esophagectomy, nodal negative or lower of LNR characteristics (P<0.05).After adjusting for potential confounders, multivariate Cox regression analysis revealed histological type, residual tumor status, depth of invasion, LN status and LNR could predict as independent prognostic factors (P<0.05). Conclusion :Number of involved lymph node can not predict survival based on our data, while LNR was more sensitive reflecting prognosis in standard lymphadenectomy during esophagectomy.

     

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