程 璞,关 旭,王锡山,等.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[J].肿瘤学杂志,2024,30(6):449-457.
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
投稿时间:2024-02-28  
DOI:10.11735/j.issn.1671-170X.2024.06.B002
中文关键词:  结直肠肿瘤  病理Ⅱ期  阳性淋巴结  预后
英文关键词:colorectal neoplasms  pathological stage Ⅱ  negative lymph node  prognosis
基金项目:中国癌症基金会北京希望马拉松专项基金(LC2021A23);科技部“常见多发病防治研究”重点专项青年科学家项目(2022YFC2505700)
作者单位
程 璞 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院 
关 旭 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院 
王锡山 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院 
郑朝旭 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院 
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中文摘要:
      摘 要:[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cN0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。
英文摘要:
      Abstract: [Objective] To explore the significance of cN+ for the number of harvested lymph nodes (LN) and prognosis of pathological stage Ⅱ colorectal cancer (CRC). [Methods] The clinical information of 23 565 pathological stage Ⅱ CRC patients from 2004 to 2015 in SEER databases and that of 454 pathological stage ⅡCRC patients from 2011 to 2015 in Cancer Hospital 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 conducted to investigate whether cN+ was the influencing factor of the number of LN or not. The effect 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 significant 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 cN0 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 stage Ⅱ CRC patients with LN≥12, cN+ is associated with a better 5-year OS.
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