Association of the tumour stroma percentage in the preoperative biopsies with lymph node metastasis in colorectal cancer
Association of the tumour stroma percentage in the preoperative biopsies with lymph node metastasis in colorectal cancer
复制标题
结直肠癌术前活检中肿瘤基质百分比与淋巴结转移的关系
DOI：
10.1038/s41416-019-0671-7
复制
发表时间：
2020-02-04
影响因子：
8.8
通讯作者：
Liu, Side
中科院分区：
文献类型：
--
作者：
Fu, Meiting;Chen, Dexin;Liu, Side
背景术前预测淋巴结 (LN) 状态对于确定结直肠癌 (CRC) 最合适的治疗策略至关重要。本研究旨在开发和验证列线图来预测 CRC 术前 LN 转移。方法 总共纳入 530 名患者并分为训练组和验证组。评估术前活检的肿瘤基质百分比（TSP）。选择淋巴结转移的危险因素，随后构建列线图。使用 AUROC 和校准曲线评估列线图的性能，然后在验证队列中进行验证。结果在训练队列和验证队列中，高 TSP 与 LN 转移显着相关。计算机断层扫描 (CT) 报告的 T 分期、CT 报告的 LN 状态、术前肿瘤分化、癌胚抗原、碳水化合物抗原 19-9 和 TSP 是 CRC 中 LN 转移的独立预测因子。构建了包含六个预测变量的列线图。列线图产生了良好的区分度和校准效果，训练组和验证组的 AUROC 分别为 0.846 (95% CI: 0.807−0.886) 和 0.809 (95% CI: 0.745−0.872)。 结论 术前活检中 TSP 的评估提供了有关 LN 状态的额外信息。列线图对于 CRC 术前的定制治疗很有用。
BackgroundPreoperative prediction of lymph node (LN) status is integral to determining the most appropriate treatment strategy for colorectal cancer (CRC). This study aimed to develop and validate a nomogram to predict LN metastasis in CRC preoperatively.MethodsA total of 530 patients were enrolled and divided into training and validation cohorts. The tumour stroma percentage (TSP) of the preoperative biopsies was assessed. The risk factors for LN metastasis were selected, and a nomogram was constructed subsequently. The performance of the nomogram was assessed by using the AUROC and the calibration curve, and then validated in the validation cohort.ResultsHigh TSP was significantly associated with LN metastasis in both the training and validation cohorts. Computed tomography (CT)-reported T stage, CT-reported LN status, preoperative tumour differentiation, carcinoembryonic antigen, carbohydrate antigen 19-9 and TSP were independent predictors of LN metastasis in CRC. A nomogram incorporating the six predictors was constructed. The nomogram yielded good discrimination and calibration, with an AUROC of 0.846 (95% CI: 0.807−0.886) and 0.809 (95% CI: 0.745−0.872) in the training and validation cohorts, respectively.ConclusionsAssessment of TSP in the preoperative biopsies provided additional information about the LN status. The nomogram was useful for tailored therapy in CRC preoperatively.