Lymph node ratio for postoperative staging of laryngeal squamous cell carcinoma with lymph node metastasis.
Lymph node ratio for postoperative staging of laryngeal squamous cell carcinoma with lymph node metastasis.
复制标题
喉鳞状细胞癌伴淋巴结转移术后分期的淋巴结比率。
DOI：
10.1371/journal.pone.0087037
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Ji QH
中科院分区：
文献类型：
--
作者：
Wang YL;Li DS;Wang Y;Wang ZY;Ji QH
淋巴结转移对喉癌预后有重要影响。淋巴结比例（LNR，转移淋巴结与检查淋巴结的比例）在喉癌分期中的作用尚未报道。分析来自监测、流行病学和最终结果数据库（SEER，训练集，N = 1963）和复旦大学上海肿瘤中心（FDSCC，验证集，N = 27）的喉癌淋巴结受损伤患者的记录，探讨LNR的预后价值。单因素和多因素分析采用Kaplan-Meier生存估计、Log-rank χ2检验和Cox比例风险模型。通过X-tile确定最佳LNR截断点。最佳LNR截断点将患者分为R1（≤0.09）、R2（0.09 - 0.20）和R3(>0.20) 3个风险组，对应SEER患者5年病因特异性生存率和总生存率分别为55.1%、40.2%、28.8%和43.1%、31.5%、21.8%，FDSCC患者2年无病生存率和疾病特异性生存率分别为74.1%、62.5%、50.0%和67.7%、43.2%、25.0%。在相同生存率的情况下，R3比N3分层更多的高危患者，R分类明确将N2患者分为3个危险组，N1患者分为2个危险组（R1-2和R3）。R分型是喉癌的重要预后因素，应作为N分型的补充分期系统。
Lymph node metastasis has a significant impact on laryngeal cancer prognosis. The role of lymph node ratio (LNR, ratio of metastatic to examined nodes) in the staging of laryngeal cancer was not reported. Records of laryngeal cancer patients with lymph node involvement from Surveillance, Epidemiology, and End Results database (SEER, training set, N = 1963) and Fudan University Shanghai Cancer Center (FDSCC, validating set, N = 27) were analyzed for the prognostic value of LNR. Kaplan–Meier survival estimates, the Log-rank χ2 test and Cox proportional hazards model were used for univariate and multivariate analysis. Optimal LNR cutoff points were identified by X-tile. Optimal LNR cutoff points classified patients into three risk groups R1 (≤0.09), R2 (0.09–0.20) and R3 (>0.20), corresponding to 5-year cause-specific survival and overall survival in SEER patients of 55.1%, 40.2%, 28.8% and 43.1%, 31.5%, 21.8%, 2-year disease free survival and disease specific survival in FDSCC patients of 74.1%, 62.5%, 50.0%, and 67.7%, 43.2%, 25.0%, respectively. R3 stratified more high risk patients than N3 with the same survival rate, and R classification clearly separated N2 patients to 3 risk groups and N1 patients to 2 risk groups (R1–2 and R3). R classification is a significant prognostic factor of laryngeal cancer and should be used as a complementary staging system of N classification.
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