Outcome prediction based on tumor stage reflected by the American Joint Committee on Cancer(AJCC)/Union for International Cancer Control(UICC)tumor node metastasis(TNM)system is currently regarded as the strongest pro...Outcome prediction based on tumor stage reflected by the American Joint Committee on Cancer(AJCC)/Union for International Cancer Control(UICC)tumor node metastasis(TNM)system is currently regarded as the strongest prognostic parameter for patients with colorectal cancer.For affected patients,the indication for adjuvant therapy is mainly guided by the presence of regional lymph node metastasis.In addition to the extent of surgical lymph node removal and the thoroughness of the pathologist in dissecting the resection specimen,several parameters that are related to the pathological work-up of the dissected nodes may affect the clinical significance of lymph node staging.These include changing definitions of lymph nodes,involved lymph nodes,and tumor deposits in different editions of the AJCC/UICC TNM system as well as the minimum number of nodes to be dissected.Methods to increase the lymph node yield in the fatty tissue include methylene blue injection and acetone compression.Outcome prediction based on the lymph node ratio,defined as the number of positive lymph nodes divided by the total number of retrieved nodes,may be superior to the absolute numbers of involved nodes.Extracapsular invasion has been identified as additional prognostic factor.Adding step sectioning and immunohistochemistry to the pathological work-up may result in higher accuracy of histological diagnosis.The clinical value of more recent technical advances,such as sentinel lymph node biopsy and molecular analysis of lymph nodes tissue still remains to be defined.展开更多
目的探讨术前中性粒细胞计数(NE)、淋巴细胞计数(LY)、血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)与声门上型喉癌颈淋巴结转移的关系。方法回顾性分析2017年1月1日至2020年8月31日于临沂市人民医院行...目的探讨术前中性粒细胞计数(NE)、淋巴细胞计数(LY)、血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)与声门上型喉癌颈淋巴结转移的关系。方法回顾性分析2017年1月1日至2020年8月31日于临沂市人民医院行手术治疗的87例声门上型喉癌患者的临床资料,根据术后病理结果分为颈淋巴结转移组37例(转移组)和无颈淋巴结转移组50例(对照组)。比较两组患者的年龄、性别、分化程度、T分期等临床资料和血常规指标(NE、LY、PLT、NLR及PLR)。对两组间存在差异的血常规指标进行受试者工作(ROC)曲线分析确定其最佳临界值。按照ROC曲线分析结果中最佳临界值对两组间存在差异的血常规指标进行赋值,赋值后行多因素Logistic回归分析。结果两组患者的年龄及性别、分化程度、T分期构成比等一般临床资料比较差异均无统计学意义(P>0.05);转移组和对照组患者的NE[(4.65±0.19)×10^(9)/L vs(3.86±0.14)×10^(9)/L]、PLT[252.11(229.00,279.50)×10^(9)/L vs 226.22(189.00,252.00)×10^(9)/L]、NLR[2.36(1.94,2.72)vs 1.77(1.40,2.06)]及PLR[(129.01±5.91)vs(103.95±4.38)]比较,转移组明显高于对照组,差异均有统计学意义(P<0.05);转移组患者的LY为2.03(1.74,2.37)×10^(9)/L,略低于对照组的2.30(1.78,2.45)×10^(9)/L,但差异无统计学意义(P>0.05);根据ROC曲线分析确定NE、PLT、NLR及PLR的最佳临界值分别为3.98、224.50、1.93、116.12;赋值后进行多因素Logistic回归分析,结果显示NLR≥1.93(OR:7.385,95%CI:1.544~35.331)及PLT≥224.50(OR:6.733,95%CI:1.531~29.597)是声门上型喉癌发生淋巴结转移的独立危险因素(P<0.05)。结论声门上型喉癌患者术前NLR和PLT显著升高与其颈淋巴结转移相关;NLR和PLT对评估声门上型喉癌颈淋巴结转移具有潜在的临床应用价值。展开更多
AIM:To investigate the relationship of solitary lymph node metastasis(SLNM)and age with patient survival in gastric cancer(GC).METHODS:The medical records databases of China’s Beijing Cancer Hospital at the Peking Un...AIM:To investigate the relationship of solitary lymph node metastasis(SLNM)and age with patient survival in gastric cancer(GC).METHODS:The medical records databases of China’s Beijing Cancer Hospital at the Peking University School of Oncology and Shanghai Tenth People’s Hospital affiliated to Tongji University were searched retrospectively to identify patients with histologically proven GC and SLNM who underwent surgical resection between October 2003 and December 2012.Patients with distant metastasis or gastric stump carcinoma following resection for benign disease were excluded from the analysis.In total,936 patients with GC+SLNM were selected for analysis and the recorded parameters of clinicopathological disease and follow-up(range:13-2925 d)were collected.The Kaplan-Meier method was used to stratify patients by age(≤50 years-old,n=198;50-64 years-old,n=321;≥65 years-old,n=446)and by metastatic lymph node ratio[MLR<0.04(1/25),n=180;0.04-0.06(1/25-1/15),n=687;≥0.06(1/15),n=98]for 5-year survival analysis.The significance of intergroup differences between the survival curves was assessed by a log-rank test. RESULTS:The 5-year survival rate of the entire GC+SLNM patient population was 49.9%.Stratification analysis showed significant differences in survival time(post-operative days)according to age:≤50 yearsold:950.7±79.0 vs 50-64 years-old:1697.8±65.9 vs≥65 years-old:1996.2±57.6,all P<0.05.In addition,younger age(≤50 years-old)correlated significantly with mean survival time(r=0.367,P<0.001).Stratification analysis also indicated an inverse relationship between increasing MLR and shorter survival time:<0.04:52.8%and 0.04-0.06:51.1%vs≥0.06:40.5%,P<0.05.The patients with the shortest survival times and rates were younger and had a high MLR(≥0.06):≤50 years-old:496.4±133.0 and 0.0%vs 50-65 years-old:1180.9±201.8 and 21.4%vs≥65 years-old:1538.4±72.4 and 37.3%,all P<0.05.The same significant trend in shorter survival times and rates for younger patients was seen with the mid-range MLR g展开更多
文摘Outcome prediction based on tumor stage reflected by the American Joint Committee on Cancer(AJCC)/Union for International Cancer Control(UICC)tumor node metastasis(TNM)system is currently regarded as the strongest prognostic parameter for patients with colorectal cancer.For affected patients,the indication for adjuvant therapy is mainly guided by the presence of regional lymph node metastasis.In addition to the extent of surgical lymph node removal and the thoroughness of the pathologist in dissecting the resection specimen,several parameters that are related to the pathological work-up of the dissected nodes may affect the clinical significance of lymph node staging.These include changing definitions of lymph nodes,involved lymph nodes,and tumor deposits in different editions of the AJCC/UICC TNM system as well as the minimum number of nodes to be dissected.Methods to increase the lymph node yield in the fatty tissue include methylene blue injection and acetone compression.Outcome prediction based on the lymph node ratio,defined as the number of positive lymph nodes divided by the total number of retrieved nodes,may be superior to the absolute numbers of involved nodes.Extracapsular invasion has been identified as additional prognostic factor.Adding step sectioning and immunohistochemistry to the pathological work-up may result in higher accuracy of histological diagnosis.The clinical value of more recent technical advances,such as sentinel lymph node biopsy and molecular analysis of lymph nodes tissue still remains to be defined.
文摘目的探讨术前中性粒细胞计数(NE)、淋巴细胞计数(LY)、血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)与声门上型喉癌颈淋巴结转移的关系。方法回顾性分析2017年1月1日至2020年8月31日于临沂市人民医院行手术治疗的87例声门上型喉癌患者的临床资料,根据术后病理结果分为颈淋巴结转移组37例(转移组)和无颈淋巴结转移组50例(对照组)。比较两组患者的年龄、性别、分化程度、T分期等临床资料和血常规指标(NE、LY、PLT、NLR及PLR)。对两组间存在差异的血常规指标进行受试者工作(ROC)曲线分析确定其最佳临界值。按照ROC曲线分析结果中最佳临界值对两组间存在差异的血常规指标进行赋值,赋值后行多因素Logistic回归分析。结果两组患者的年龄及性别、分化程度、T分期构成比等一般临床资料比较差异均无统计学意义(P>0.05);转移组和对照组患者的NE[(4.65±0.19)×10^(9)/L vs(3.86±0.14)×10^(9)/L]、PLT[252.11(229.00,279.50)×10^(9)/L vs 226.22(189.00,252.00)×10^(9)/L]、NLR[2.36(1.94,2.72)vs 1.77(1.40,2.06)]及PLR[(129.01±5.91)vs(103.95±4.38)]比较,转移组明显高于对照组,差异均有统计学意义(P<0.05);转移组患者的LY为2.03(1.74,2.37)×10^(9)/L,略低于对照组的2.30(1.78,2.45)×10^(9)/L,但差异无统计学意义(P>0.05);根据ROC曲线分析确定NE、PLT、NLR及PLR的最佳临界值分别为3.98、224.50、1.93、116.12;赋值后进行多因素Logistic回归分析,结果显示NLR≥1.93(OR:7.385,95%CI:1.544~35.331)及PLT≥224.50(OR:6.733,95%CI:1.531~29.597)是声门上型喉癌发生淋巴结转移的独立危险因素(P<0.05)。结论声门上型喉癌患者术前NLR和PLT显著升高与其颈淋巴结转移相关;NLR和PLT对评估声门上型喉癌颈淋巴结转移具有潜在的临床应用价值。
基金Supported by Grants awarded to Dr.Chun-Qiu Chen from the National Science Foundation of China,No.81170345the Shanghai Tenth People’s Hospital Project for Cultivating Tutors of Doctors,No.12HBBD110
文摘AIM:To investigate the relationship of solitary lymph node metastasis(SLNM)and age with patient survival in gastric cancer(GC).METHODS:The medical records databases of China’s Beijing Cancer Hospital at the Peking University School of Oncology and Shanghai Tenth People’s Hospital affiliated to Tongji University were searched retrospectively to identify patients with histologically proven GC and SLNM who underwent surgical resection between October 2003 and December 2012.Patients with distant metastasis or gastric stump carcinoma following resection for benign disease were excluded from the analysis.In total,936 patients with GC+SLNM were selected for analysis and the recorded parameters of clinicopathological disease and follow-up(range:13-2925 d)were collected.The Kaplan-Meier method was used to stratify patients by age(≤50 years-old,n=198;50-64 years-old,n=321;≥65 years-old,n=446)and by metastatic lymph node ratio[MLR<0.04(1/25),n=180;0.04-0.06(1/25-1/15),n=687;≥0.06(1/15),n=98]for 5-year survival analysis.The significance of intergroup differences between the survival curves was assessed by a log-rank test. RESULTS:The 5-year survival rate of the entire GC+SLNM patient population was 49.9%.Stratification analysis showed significant differences in survival time(post-operative days)according to age:≤50 yearsold:950.7±79.0 vs 50-64 years-old:1697.8±65.9 vs≥65 years-old:1996.2±57.6,all P<0.05.In addition,younger age(≤50 years-old)correlated significantly with mean survival time(r=0.367,P<0.001).Stratification analysis also indicated an inverse relationship between increasing MLR and shorter survival time:<0.04:52.8%and 0.04-0.06:51.1%vs≥0.06:40.5%,P<0.05.The patients with the shortest survival times and rates were younger and had a high MLR(≥0.06):≤50 years-old:496.4±133.0 and 0.0%vs 50-65 years-old:1180.9±201.8 and 21.4%vs≥65 years-old:1538.4±72.4 and 37.3%,all P<0.05.The same significant trend in shorter survival times and rates for younger patients was seen with the mid-range MLR g
