A prognostic model to predict survival in stage III colon cancer patients based on histological grade, preoperative carcinoembryonic antigen level and the neutrophil lymphocyte ratio.
A prognostic model to predict survival in stage III colon cancer patients based on histological grade, preoperative carcinoembryonic antigen level and the neutrophil lymphocyte ratio.
复制标题
基于组织学分级、术前癌胚抗原水平和中性粒细胞比率来预测 III 期结肠癌患者生存的预后模型。
DOI：
10.7314/apjcp.2015.16.2.747
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Z. Xia
中科院分区：
文献类型：
--
作者：
Zhi;Hai;Kefeng Wang;Xiao‐qin Chen;X. Hao;Yanyi Lu;Z. Xia
背景
III期结肠癌患者表现出不同的临床结果。本研究的目的是开发一个预后模型，以便更好地预测其生存。
材料和方法
回顾性分析2004年至2010年的548例患者，其中328例被定义为研究组，其余220例作为验证组。收集患者的年龄、性别、组织学分级、T分期、阳性淋巴结数、收获淋巴结数、治疗前癌胚抗原（CEA）水平和治疗前中性粒细胞淋巴细胞比率（NLR）。Kaplan-Meier生存曲线用于检测预后因素，多变量分析用于确定独立的例子，在此基础上建立预后模型。最后，与验证小组对模型进行了进一步验证。
结果
组织学分级（p=0.002），T分期（p=0.011），阳性淋巴结数量（p=0.003），收获的淋巴结数量（p=0.020），CEA（p=0.005）和NLR（p<0.001）为预后因素，而组织学分级[RR（相对风险）：0.632，95%CI CEA（RR：0.644，95%CI：0.431~0.964，p= 0.033）和NLR（RR：0.384，95%CI：0.255~0.580，p<0.001）水平是独立的。基于这三个因素的预后模型能够将患者分为高风险、中等风险和低风险组（p<0.001），无论是在研究组还是验证组。
结论
组织学分级、治疗前CEA和NLR水平是III期结肠癌患者的独立预后因素。基于这些因素的预后模型在未来的临床实践中值得关注。
BACKGROUND
Stage III colon cancer patients demonstrate diverse clinical outcomes. The aim of this study was to develop a prognostic model in order to better predict their survival.
MATERIALS AND METHODS
From 2004 to 2010, 548 patients were retrospectively analyzed, among whom 328 were defined as the study group and the remaining 220 served as a validation group. Clinico-pathologic features, including age, gender, histological grade, T stage, number of positive lymph nodes, number of harvest lymph nodes, pretreatment carcinoembryonic antigen (CEA) levels and pretreatment neutrophil lymphocyte ratio (NLR), were collected. Kaplan-Meier survival curves were used to detect prognostic factors and multivariate analysis was applied to identify independent examples on which to develop a prognostic model. Finally, the model was further validated with the validation group.
RESULTS
Histological grade (p=0.002), T stage (p=0.011), number of positive lymph nodes (p=0.003), number of harvested lymph nodes (p=0.020), CEA (p=0.005), and NLR (p<0.001) were found as prognostic factors while histological grade [RR(relative risk):0.632, 95%CI (Confidence interval) 0.405~0.985, p=0.043], CEA (RR:0.644, 95%CI:0.431~0.964, p=0.033) and NLR (RR:0.384, 95%CI:0.255~0.580, p<0.001) levels were independent. The prognostic model based on these three factors was able to classify patients into high risk, intermediate and low risk groups (p<0.001), both in study and validation groups.
CONCLUSIONS
Histological grade, pretreatment CEA and NLR levels are independent prognostic factors in stage III colon cancer patients. A prognostic model based on these factors merits attention in future clinical practice.
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影响因子：
45.3
作者：
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通讯作者：
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Goldberg, Richard M.