放射性淋巴结大小改善了病理阴性淋巴结直肠癌中系统性炎症指数的预后价值。
Radiological lymph-node size improves the prognostic value of systemic inflammation index in rectal cancer with pathologically negative nodes.
发表日期：2023 Mar 20
作者：
Shaoyong Peng, Xiaoxia Liu, Yingjie Li, Huichuan Yu, Yumo Xie, Xiaolin Wang, Jiaming Zhou, Mingxuan Zhu, Yanxin Luo, Meijin Huang
来源：
Disease Models & Mechanisms
摘要：
放射学淋巴结（rLN）大小与无淋巴结受累直肠癌患者的生存结果之间的关系仍不确定。本研究旨在探索扩大的rLN在预测无淋巴结受累直肠癌患者生存方面的作用。我们对722例接受根治手术的无淋巴结受累直肠癌患者记录进行了回顾性分析。使用单变量和多变量分析评估与DFS（无病存活期）和CSS（癌症特异性生存期）相关的因素。根据是否存在扩大的rLN进行生存分析。将rLN与NLR合并为新的炎性免疫评分（IIS）指数，用于预测生存。比较不同模型以评估预测能力。共有119名患者肿瘤复发，73名患者因癌症死亡。扩大的rLN（≥5mm）与更好的DFS（HR：0.517、95％CI：0.339-0.787、p = 0.002）和CSS（HR：0.43、95％CI：0.242-0.763、p = 0.004）显着相关。复发的风险因素包括rLN、嗜中性粒细胞-淋巴细胞比（NLR）、CEA水平和肛缘距离。高得分组相对于低和中间得分组，复发风险增加了1.88倍和2.83倍（所有p <0.001）。同样，高IIS得分也增加了癌症特异性死亡风险。在模型比较中，将rLN纳入NLR模型中以预测DFS和CSS可以改善AIC和LR（所有p <0.05）。扩大的rLN的无淋巴结受累直肠癌患者具有更好的生存结果。IIS可能是更全面和完整的炎性免疫指标，用于预测生存。 © 2023 The Authors. 由John Wiley＆Sons Ltd.出版的《癌症医学》。
The relationship between the radiological lymph node (rLN) size and survival outcome in node-negative rectal cancer is still uncertain. In this study, we aimed to explore the role of enlarged rLN in predicting the survival of node-negative rectal cancers.We retrospectively reviewed the records of 722 node-negative rectal cancer who underwent curative resection. Factors associated with DFS (disease-free survival) and CSS (cancer-specific survival) were assessed with univariate and multivariate analysis. Survival analysis was performed according to presence with or without enlarged rLN. Combining rLN with NLR as a new index-inflammation immune score (IIS) for predicting survival. Comparing different models to assess the predictive powers.A total of 119 patients had tumor recurrence and 73 patients died due to cancer. Patients with enlarged rLN (≥5 mm) was significantly associated with better DFS (HR:0.517, 95%CI:0.339-0.787, p = 0.002) and CSS (HR:0.43, 95%CI:0.242-0.763, p = 0.004). The risk factors of recurrence were rLN, neutrophil-lymphocyte ratio (NLR), CEA level, and distance from the anal verge. The risk of recurrence increased by 1.88- and 2.83-fold for the high score in IIS compared with the low and intermediate score group (All p < 0.001). Similarly, the high score in IIS also increased the risk of cancer-specific death. In the model comparison, the AIC and LR were improved by including the rLN into the NLR model for DFS and CSS prediction (All p < 0.05).Node-negative rectal cancer patients with enlarged rLN had a better survival outcome. IIS might be a more comprehensive and complete inflammation immune index for survival prediction.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.