Integrated ratio of metastatic to examined lymph nodes and number of metastatic lymph nodes into the AJCC staging system for colon cancer.
Integrated ratio of metastatic to examined lymph nodes and number of metastatic lymph nodes into the AJCC staging system for colon cancer.
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将转移淋巴结与检查淋巴结的比率以及转移淋巴结数量纳入 AJCC 结肠癌分期系统
DOI：
10.1371/journal.pone.0035021
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Xu HM
中科院分区：
文献类型：
--
作者：
Gao P;Song YX;Wang ZN;Xu YY;Tong LL;Zhu JL;Tang QC;Xu HM
目的目前AJCC结肠癌TNM系统pN分类仅以淋巴结转移数（LNs+）为依据。最近，转移淋巴结与检查淋巴结（LNR）的比值已被报道代表结肠癌的强大独立预测能力。我们试图提出一种新的分类（nLN），将LNR和LN+纳入AJCC结肠癌分期系统。设计34476例患者从国家癌症研究所的监测，流行病学和最终结果（SEER）数据集与III期结肠癌进行了审查。Harrell's C统计量用于评估预测能力。考克斯比例风险模型被用来构建一个新的类别。结果在所有患者组中，LNR分类比pN分类具有更高的预测能力（Harrell's C指数：0.6194 vs 0.6113，p = 0.003）。 亚组分析表明，如果检查的淋巴结数量超过13个，LNR分类的预测能力并不比pN分类好。我们还发现在同一LNR分类下，不同pN分类之间存在显著的生存异质性（P<0.001）。nLN组的Harrell C指数为0.6228，显著高于pN组（Harrell C指数：0.6113，P<0.001）和LNR组（Harrell C指数：0.6194，P = 0.005）。 结论在评估结肠癌的预后时，我们的nLN分类法（将LNR与LNs+结合起来）分别比pN分类法和LNR分类法更准确。
Objective At present, only the number of metastatic lymph nodes (LNs+) is used for the pN category of AJCC TNM system for colon cancer. Recently, the ratio of metastatic to examined lymph nodes (LNR) has been reported to represent powerful independent predictive capacity in colon cancer. We sought to propose a novel category (nLN) which intergrades LNR and LNs+ into the AJCC staging system for colon cancer. Design 34476 patients from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) dataset with stage III colon cancer were reviewed. Harrell's C statistic was used to evaluate the predictive capacity. The Cox proportional hazards model was used to construct a novel category. Results The LNR category had more predictive capacity than the pN category in whole groups of patients (Harrell's C index: 0.6194 vs 0.6113, p = 0.003). Subgroup analysis showed that the LNR category was not better than pN category in predictive capacity if the number of lymph nodes examined was more than 13. We also found that there was significant survival heterogeneity among different pN categories at the same LNR category (P<0.001). The Harrell's C index for our nLN category which intergrades LNR and LNs+ was 0.6228, which was significant higher than that of the pN category (Harrell's C index: 0.6113, P<0.001) or LNR category (Harrell's C index: 0.6194, P = 0.005), respectively. Conclusion To evaluate the prognosis of colon cancer, our nLN category which intergrades LNR with LNs+ is more accurate than the pN category or LNR category, respectively.
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影响因子：
3.7
作者：
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Kim, Hyeong Rok
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影响因子：
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作者：
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