The Use of Ratio of Metastasis in Lymph Nodes as a Predictor of Overall Survival in Colorectal Cancer

淋巴轉移數目對淋巴總數的比例也許可成為大腸直腸癌的存活偵測因子

陳懿文(I-Wen Chen) ； 王瑞和(Jui-Ho Wang) ； 金台明(Tai-Ming King) ； 歐陽賦(Fu-Ou Yang) ； 王心泰(Hsin-Tai Wang) ； 歐文傑

《中華民國大腸直腸外科醫學會雜誌》 20卷3期 (2009/09) Pp. 56-61

https://doi.org/10.6312/SCRSTW.2009.20(3).09806

摘要

目的　本篇研究的目的在於評估淋巴結比率的重要性，它在第三期大腸直腸癌中是否可爲預後偵測因子，我們假設淋巴結比率在第三期大腸直腸癌的存活率也許扮演重要的角色。
方法　此研究分析1998年1月至2002年12月共109位接受大腸直腸癌根除手術的患者（男性共73位，女性共36位）。淋巴病變是依據美國癌症聯合會來分類，淋巴結比率用四分位法來計算分成四組。由Kaplan-Meier分析法和log rank test來計算存活率。患者年齡範圍從27歲到86歲（平均63歲）。
結果　在1998年到2002年期間，在本院共計有884位大腸直腸癌患者。這篇研究中，選擇第三期的患者共有109位。73位爲男性（佔67%），36位女性（佔33%）。平均年齡63歲，且每位患者獲得的淋巴總數至少10顆。在淋巴結比率四分位的四個群組中，在整體存活有明顯的不同。根據我們的分析，第一組的五年整體存活率爲75%，而第四組五年整體存活率卻低於23%。
結論　淋巴結比率合併了淋巴結轉移的數目和切除的淋巴總數，而上述兩者爲獨立的預後重要因子。在第三期的大腸直腸癌患者，淋巴結比率也許可成爲有利的預後偵測因子。

關鍵字

大腸直腸癌 ； 淋巴結比率 ； 預後偵測因子

並列摘要

Purpose. The evaluated the use of lymph node ratio (LNR) as a prognostic predictor for patients with stage Ⅲ colorectal cancer.
Materials and Methods. We retrospectively and consecutively reviewed the records of 109 colorectal cancer patients who had received curative resection at Veteran General Hospital Kaohsiung (VGHKS) between January 1998 to December 2002. Lymph node (LN) disease was diagnosed and staged into quartiles according criteria established by the American Joint Committee on Cancer. Survival was calculated by Kaplan-Meier analysis and was assessed by the log rank test. The lymph node ratio was calculated by dividing the number of disease positive lymph nodes with the total number of resected nodes, both variables previously reported to be of independent prognostic importance.
Result. Eight hundred eighty-four patients were diagnosed with colorectal cancer in our hospital between 1998 and 2002. We selected 109 patients with stage Ⅲ disease. Seventy-three (67%) were men and 36 women (33%) with median age was 63 years (range 27 to 86). In each patient, a minimum of 10 LNs were harvested. We found a significant difference in overall survival among the four groups analyzed by LN ratio quartiles: group 1 had an LNR less than 0.25; group 2, 0.25-0.5; group 3, 0.5-0.75; and group 4, 0.75-1.0.) The 5-year survival rate of those in group 1 was 75% but for those in group 4, it was 23% (P＜0.007).
Conclusion. This study suggests that LNR can be used as a potent predictor of survival for patients with stage Ⅲ colorectal carcinoma.

並列關鍵字

Colorectal cancer ； Predictor ； Survival ； Lymph node ratio