The ratio of metastatic/resected lymph nodes is an independent prognostic factor in patients with node-positive pancreatic head cancer
The ratio of metastatic/resected lymph nodes is an independent prognostic factor in patients with node-positive pancreatic head cancer
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DOI：
10.1097/01.mpa.0000235306.96486.2a
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发表时间：
2006-10-01
期刊：
影响因子：
2.9
通讯作者：
Nowak, Krystyna
中科院分区：
文献类型：
--
作者：
Sierzega, Marek;Popiela, Tadeusz;Nowak, Krystyna
目的：本研究的目的是评估淋巴结受累对胰头腺癌切除的预后价值。方法：1980 年至 2002 年间，96 名患者因胰腺癌接受了胰十二指肠切除术。根据日本胰腺学会的规则对淋巴结进行编号并分组。根据苏木精和伊红染色鉴定转移性淋巴结。结果：64 例（66.7%）患者淋巴结阳性。转移淋巴结的中位数为 2 个（95% 置信区间 [CI]，1.0-3.0），转移/切除淋巴结的中位数比率为 9.7%（95% CI，7.1%-14.4%）。淋巴结阴性患者的中位生存期为 14.2 个月（95% CI，10.7-17.7），显着高于淋巴结阳性患者（27.9；95% Cl，20.9-34.9 vs. 10.6；95% Cl，8.7-12.5；P < 0.001）。包括所有患者的 Cox 比例风险模型表明，淋巴结受累（风险比 [HR]，1.461；95% Cl，1.177-12.024）、中度或较差的肿瘤分化（FIR，2.330；95% Cl，1.181-6.949）和阳性切除切缘（FIR，3.838；95% Cl， 1.390-10.597）是独立的负面预后因素。如果分析仅限于淋巴结阳性患者，则淋巴结比例超过 20%（HR，1.364；95% Cl，1.116-2.599），肿瘤分化程度中等或较差（FIR，3.393；95% Cl，1.041-11.061），且切除切缘阳性（HR，9.400；95% Cl， 2.235-39.536) 与较差的生存率显着相关。结论：淋巴结比率似乎是淋巴结阳性胰头癌患者的一个新的有希望的预后因素。
Objectives: The aim of this study was to evaluate the prognostic value of nodal involvement in resected adenocarcinoma of the pancreatic head.Methods: For the period between 1980 and 2002, 96 patients underwent pancreaticoduodenectomy for pancreatic cancer. Lymph nodes were numbered and classified into groups according to the Japan Pancreatic Society rules. Metastatic lymph nodes were identified based on hematoxylin and eosin staining.Results: Sixty-four (66.7%) patients had positive lymph nodes. The median number of metastatic nodes was 2 (95% confidence interval [CI], 1.0-3.0) and the median ratio of metastatic/resected nodes was 9.7% (95% Cl, 7.1%-14.4%). The median survival was 14.2 months (95% Cl, 10.7-17.7) and was significantly higher for node-negative than node-positive patients (27.9; 95% Cl, 20.9-34.9 vs. 10.6; 95% Cl, 8.7-12.5; P < 0.001). The Cox proportional hazards model, including all patients, demonstrated that nodal involvement (hazard ratio [HR], 1.461; 95% Cl, 1.177-12.024), moderate or poor tumor differentiation (FIR, 2.330; 95% Cl, 1.181-6.949), and positive resection margins (FIR, 3.838; 95% Cl, 1.390-10.597) were independent negative prognostic factors. If the analysis was limited to node-positive patients, lymph node ratio of more than 20% (HR, 1.364; 95% Cl, 1.116-2.599), moderate or poor tumor differentiation (FIR, 3.393; 95% Cl, 1.041-11.061), and positive resection margins (HR, 9.400; 95% Cl, 2.235-39.536) significantly correlated with a poorer survival.Conclusions: Lymph node ratio seems to be a new promising prognostic factor in patients with respectable node-positive pancreatic head cancer.