建议使用淋巴结比率 (LNR) 来解决仅使用淋巴结产量 (LNY) 或结直肠癌 (CRC) 预后状态的缺点。本研究探讨了 LNR 如何影响转移性结直肠癌 (mCRC) 患者的生存，旨在为其应用提供更清晰的见解。这项观察性队列研究调查了接受了原发肿瘤前期切除术的 IV 期 CRC 患者（1995-2021 年）在悉尼康科德医院。从前瞻性数据库中提取临床病理数据，并连续和二分法计算LNR（LNR of 0和LNR > 0）。主要终点是总生存期（OS）。使用回归分析测试 LNR 与各种临床病理学变量之间的关联。 Kaplan-Meier 和 Cox 回归分析估计了单变量和多变量生存模型中的 OS。 共有 464 名接受原发性 CRC 切除且切缘清晰的患者（平均年龄 68.1 岁 [SD 13.4]；58.0% M；结肠癌 [n = 339]） ,73.1%]）患有 AJCC IV 期疾病。结肠癌 (CC) 切除术的中位 LNR 为 0.18 (IQR 0.05-0.42)，直肠癌 (RC) 切除术的中位 LNR 为 0.21 (IQR 0.09-0.47)。共有 84 名患者的 LNR = 0（CC = 66 名患者；RC = 18 名患者）。 CC 队列的 5 年 OS 为 10.5% (95% CI 8.7-12.3)，RC 队列为 11.5% (95% CI 8.4-14.6)。 LNR 的增加表明 CC (P<0.001) 和 RC (P<0.001) 的 OS 均下降。仅发生非淋巴扩散的患者（LNR = 0 或 N0 状态）与发生淋巴扩散的患者相比，生存率更高（CC aHR1.50 [1.08-2.07；P = 0.02]，RC aHR 2.21 [1.16-4.24；P = 0.02]，RC aHR 2.21 [1.16-4.24； P = 0.02]).LNR 在 mCRC 患者中值得考虑。 LNR 为 0 表明患者预后较好，强调需要进行充分的淋巴结切除术以促进精确的 mCRC 分期。© 2024。作者。

Lymph node ratio (LNR) is suggested to address the shortcomings of using only lymph node yield (LNY) or status in colorectal cancer (CRC) prognosis. This study explores how LNR affects survival in patients with metastatic colorectal cancer (mCRC), seeking to provide clearer insights into its application.This observational cohort study investigated stage IV patients with CRC (1995-2021) who underwent an upfront resection of their primary tumour at Concord Hospital, Sydney. Clinicopathological data were extracted from a prospective database, and LNR was calculated both continuously and dichotomously (LNR of 0 and LNR > 0). The primary endpoint was overall survival (OS). The associations between LNR and various clinicopathological variables were tested using regression analyses. Kaplan-Meier and Cox regression analyses estimated OS in univariate and multivariate survival models.A total of 464 patients who underwent a primary CRC resection with clear margins (mean age 68.1 years [SD 13.4]; 58.0% M; colon cancer [n = 339,73.1%]) had AJCC stage IV disease. The median LNR was 0.18 (IQR 0.05-0.42) for colon cancer (CC) resections and 0.21 (IQR 0.09-0.47) for rectal cancer (RC) resections. A total of 84 patients had an LNR = 0 (CC = 66 patients; RC = 18 patients). The 5-year OS for the CC cohort was 10.5% (95% CI 8.7-12.3) and 11.5% (95% CI 8.4-14.6) for RC. Increasing LNR demonstrated a decline in OS in both CC (P < 0.001) and RC (P < 0.001). In patients with non-lymphatic dissemination only (LNR = 0 or N0 status), there was better survival compared with those with lymphatic spread (CC aHR1.50 [1.08-2.07;P = 0.02], RC aHR 2.21 [1.16-4.24;P = 0.02]).LNR is worthy of consideration in patients with mCRC. An LNR of 0 indicates patients have a better prognosis, underscoring the need for adequate lymphadenectomy to facilitate precise mCRC staging.© 2024. The Author(s).