摘要
目的探讨阳性淋巴结对数比值比(LODDs)评估宫颈癌根治术和辅助放疗后患者预后的价值。方法选择2013年3月至2014年6月在我院行根治术后行辅助放疗的宫颈癌患者100例回顾性分析。所有患者均行根治性子宫切除术同时行盆腔淋巴结清扫术,术后性辅助放疗。收集患者病历资料并进行随访。对LODDS评估宫颈癌根治术和辅助放疗后患者预后进行受试者操作特征曲线(ROC)分析,并对无病生存期(DFS)与总生存期(OS)进行单因素分析与多因素分析。结果全组LODDS中位数为-1.05,LODDS为-1.05为最佳阈值,其灵敏度为72.83%,特异度为71.88%,曲线下面积为0.888(P<0.05)。单因素分析结果显示神经侵袭、LN入侵次数、上LN参与(包括髂总淋巴结或主动脉旁淋巴结)、受累淋巴结比值(LNR)及LODDS不同DFS差异具有统计学意义(P<0.05),淋巴血管侵袭、神经侵袭、LN入侵次数、LODDS不同OS差异具有统计学意义(P<0.05)。OS多因素分析结果显示LN入侵次数[HR:0.655,95CI%(0.379,0.954)]及LODDS [HR:2.557,95CI%(1.352,3.527)]为影响患者术后OS的独立性影响因素(P<0.05)。结论对于宫颈癌根治术和辅助放疗后患者LODDS具有显著的预后预测优势,LODDS为-1.05为最佳阈值,大于该值时患者预后较差。
Objective To determine the value of log odds of positive lymph nodes(LODDS) in the prognostic evaluation of patients following radical resection of cervical cancer and adjuvant radiotherapy. Methods This retrospective study enrolled 100 patients with cervical cancer who underwent adjuvant radiotherapy after radical surgery in our hospital between March 2013 and June 2014. All patients underwent radical hysterectomy plus pelvic lym-phadenectomy and postoperative adjuvant radiotherapy. The patients were reviewed for medical records and followed up. ROC analysis was performed on the performance of LODDS in evaluating the prognosis of patients undergoing rad-ical resection of cervical cancer and adjuvant radiotherapy. Disease-free survival(DFS) and overall survival(OS) were also evaluated by univariate and multivariate analyses. Results The median LODDS in this cohort was-1.05, with-1.05 being the optimal cut-off. Using this optimal cut-off, the sensitivity was 72.83%, the specificity was 71.88%,and the area under the curve was 0.888(P<0.05) for predicting a poor prognosis. Univariate analysis showed that DFS differed significantly with neural invasion, number of metastatic lymph nodes(LNs) invasions, involvement of supra-iliac LNs(including common iliac or paravaortic lymph nodes), metastatic lymph node ratio(LNR), and LODDS( P <0.05), and that OS differed significantly with lymphovascular invasion, neural invasion, number of metastatic LNs, and LODDS(P<0.05). Multivariate analysis showed that the number of metastatic LNs [HR: 0.655, 95 CI%(0.379,0.954)]and LODDS [HR: 2.557, 95 CI%(1.352,3.527)] were independent factors affecting the postoperative OS(P <0.05).Conclusion LODDS offers significant advantage in predicting the prognosis of patients with cervical cancer after radical surgery and adjuvant radiotherapy. A LODDS value greater that the optimal cut-off(-1.05) may suggest poor prognosis.
作者
陈翎
Chen Ling(Department of Gynecology, Shanxi Provincial People′s Hospital, Taiyuan 030012, China)
出处
《中国药物与临床》
CAS
2019年第15期2548-2551,共4页
Chinese Remedies & Clinics
关键词
宫颈肿瘤
辅助放疗
预后
阳性淋巴结对数比值比
Cervix neoplasms
Adjuvant radiotherapy
Prognosis
Log odds of positive lymph nodes
