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Superiority of metastatic lymph node ratio to the 7th edition UICC N staging in gastric cancer 认领 引用 被引量：19
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作者 Long-Bin Xiao Jian-Xing Yu +2 位作者 Wen-Hui Wu Feng-Feng Xu Shi-Bin Yang 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第46期5123-5130,共8页
AIM:To compare and evaluate the appropriate prog-nostic indicators of lymph node basic staging in gastric cancer patients who underwent radical resection.METHODS:A total of 1042 gastric cancer patients who underwent r... AIM:To compare and evaluate the appropriate prog-nostic indicators of lymph node basic staging in gastric cancer patients who underwent radical resection.METHODS:A total of 1042 gastric cancer patients who underwent radical resection and D2 lymphadenectomy were staged using the 6th and 7th edition International Union Against Cancer(UICC)N staging methods and the metastatic lymph node ratio(MLNR)staging.Ho-mogeneity,discriminatory ability,and gradient mono-tonicity of the various staging methods were compared using linear trendχ2,likelihood ratioχ2 statistics,and Akaike information criterion(AIC)calculations.The area under the curve(AUC)was calculated to compare the predictive ability of the aforementioned three stag-ing methods.RESULTS:Optimal cut-points of the MLNR were cal-culated as MLNR0(0),MLNR1(0.01-0.30),MLNR2(0.31-0.50),and MLNR3(0.51-1.00).In univariate,multivariate,and stratified analyses,MLNR staging was superior to the 6th and 7th edition UICC N stag-ing methods.MLNR staging had a higher AUC,higher linear trend and likelihood ratioχ2 scores and lower AIC values than the other two staging methods.CONCLUSION:MLNR staging predicts survival after gastric cancer more precisely than the 6th and 7th edi-tion UICC N classif ications and should be considered as an alternative to current pathological N staging. 展开更多
关键词 Gastric cancer Metastatic lymph node ratio Prognosis
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Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus 认领 引用 被引量：11
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作者 Chang-Ming Huang Bi-Juan Lin +3 位作者 Hui-Shan Lu Xiang-Fu Zhang Ping Li Jian-Wei Xie 《World Journal of Gastroenterology》 SCIE CAS 2008年第27期4383-4388,共6页
AIM:To investigate the prognostic impact of the metastatic lymph node ratio(MLR)in advanced gastric cancer from the cardia and fundus.METHODS:Two hundred and thirty-six patients with gastric cancer from the cardia and... AIM:To investigate the prognostic impact of the metastatic lymph node ratio(MLR)in advanced gastric cancer from the cardia and fundus.METHODS:Two hundred and thirty-six patients with gastric cancer from the cardia and fundus who underwent D2 curative resection were analyzed ret-rospectively.The correlations between MLR and the total lymph nodes,positive nodes and the total lymph nodes were analyzed respectively.The influence of MLR on the survival time of patients was determined with univariate Kaplan-Meier survival analysis and mul-tivariate Cox proportional hazard model analysis.And the multiple linear regression was used to identify the relation between MLR and the 5-year survival rate of the patients.RESULTS:The MLR did not correlate with the total lymph nodes resected(r=-0.093,P=0.057).The 5-year overall survival rate of the whole cohort was 37.5%.Kaplan-Meier survival analysis identified that the following eight factors influenced the survival time of the patients postoperatively:gender(χ2=4.26,P=0.0389),tumor size(χ2=18.48,P<0.001),Borrmann type(χ2=7.41,P=0.0065),histological grade(χ2=5.07,P=0.0243),pT category(χ2=49.42,P<0.001),pN category(χ2=87.7,P<0.001),total number of re-trieved lymph nodes(χ2=8.22,P=0.0042)and MLR(χ2=34.3,P<0.001).Cox proportional hazard model showed that tumor size(χ2=7.985,P=0.018),pTcategory(χ2=30.82,P<0.001)and MLR(χ2=69.39,P<0.001)independently influenced the prognosis.A linear correlation between MLR and the 5-year survival was statistically significant based on the multiple lin-ear regression(β=-0.63,P<0.001).Hypothetically,the 5-year survival would surpass 50%when MLR was lower than 10%.CONCLUSION:The MLR is an independent prognostic factor for patients with advanced gastric cancer from the cardia and fundus.The decrease of MLR due to adequate number of total resected lymph nodes can improve the survival. 展开更多
关键词 Stomach neoplasms Lymph node metas-tasis Metastatic lymph node ratio Lymphadenectomy Prognosis
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Predictive value of positive lymph node ratio in patients with locally advanced gastric remnant cancer 认领 引用 被引量：3
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作者 Meng Zhuo Lei Tian +3 位作者 Ting Han Teng-Fei Liu Xiao-Lin Lin Xiu-Ying Xiao 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第3期833-843,共11页
BACKGROUND Traditional lymph node stage(N stage)has limitations in advanced gastric remnant cancer(GRC)patients;therefore,establishing a new predictive stage is necessary.AIM To explore the predictive value of positiv... BACKGROUND Traditional lymph node stage(N stage)has limitations in advanced gastric remnant cancer(GRC)patients;therefore,establishing a new predictive stage is necessary.AIM To explore the predictive value of positive lymph node ratio(LNR)according to clinicopathological characteristics and prognosis of locally advanced GRC.METHODS Seventy-four patients who underwent radical gastrectomy and lymphadenectomy for locally advanced GRC were retrospectively reviewed.The relationship between LNR and clinicopathological characteristics was analyzed.The survival analysis was performed using Kaplan-Meier survival curves and Cox regression model.RESULTS Number of metastatic LNs,tumor diameter,depth of tumor invasion,Borrmann type,serum tumor biomarkers,and tumor-node-metastasis(TNM)stage were correlated with LNR stage and N stage.Univariate analysis revealed that the factors affecting survival included tumor diameter,anemia,serum tumor biomarkers,vascular or neural invasion,combined resection,LNR stage,N stage,and TNM stage(all P<0.05).The median survival time for those with LNR0,LNR1,LNR2 and LNR3 stage were 61,31,23 and 17 mo,respectively,and the differences were significant(P=0.000).Anemia,tumor biomarkers and LNR stage were independent prognostic factors for survival in multivariable analysis(all P<0.05).CONCLUSION The new LNR stage is uniquely based on number of metastatic LNs,with significant prognostic value for locally advanced GRC,and could better differentiate overall survival,compared with N stage. 展开更多
关键词 Gastric remnant cancer Positive lymph node ratio Clinicopathological characteristics Prognosis
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Combining lymph node ratio to develop prognostic models for postoperative gastric neuroendocrine neoplasm patients 认领 引用 被引量：2
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作者 Wen Liu Hong-Yu Wu +4 位作者 Jia-Xi Lin Shu-Ting Qu Yi-Jie Gu Jin-Zhou Zhu Chun-Fang Xu 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第8期3507-3520,共14页
BACKGROUND Lymph node ratio(LNR)was demonstrated to play a crucial role in the prognosis of many tumors.However,research concerning the prognostic value of LNR in postoperative gastric neuroendocrine neoplasm(NEN)pati... BACKGROUND Lymph node ratio(LNR)was demonstrated to play a crucial role in the prognosis of many tumors.However,research concerning the prognostic value of LNR in postoperative gastric neuroendocrine neoplasm(NEN)patients was limited.AIM To explore the prognostic value of LNR in postoperative gastric NEN patients and to combine LNR to develop prognostic models.METHODS A total of 286 patients from the Surveillance,Epidemiology,and End Results database were divided into the training set and validation set at a ratio of 8:2.92 patients from the First Affiliated Hospital of Soochow University in China were designated as a test set.Cox regression analysis was used to explore the relationship between LNR and disease-specific survival(DSS)of gastric NEN patients.Random survival forest(RSF)algorithm and Cox proportional hazards(CoxPH)analysis were applied to develop models to predict DSS respectively,and compared with the 8th edition American Joint Committee on Cancer(AJCC)tumornode-metastasis(TNM)staging.RESULTS Multivariate analyses indicated that LNR was an independent prognostic factor for postoperative gastric NEN patients and a higher LNR was accompanied by a higher risk of death.The RSF model exhibited the best performance in predicting DSS,with the C-index in the test set being 0.769[95%confidence interval(CI):0.691-0.846]outperforming the CoxPH model(0.744,95%CI:0.665-0.822)and the 8th edition AJCC TNM staging(0.723,95%CI:0.613-0.833).The calibration curves and decision curve analysis(DCA)demonstrated the RSF model had good calibration and clinical benefits.Furthermore,the RSF model could perform risk stratification and individual prognosis prediction effectively.CONCLUSION A higher LNR indicated a lower DSS in postoperative gastric NEN patients.The RSF model outperformed the CoxPH model and the 8th edition AJCC TNM staging in the test set,showing potential in clinical practice. 展开更多
关键词 Gastric neuroendocrine neoplasm Lymph node ratio Disease-specific survival Random survival forest Predictive model
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Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy 认领 引用 被引量：24
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作者 Huang, Chang-Ming Lin, Jian-Xian +4 位作者 Zheng, Chao-Hui Li, Ping Xie, Jian-Wei Lin, Bi-Juan Wang, Jia-Bin 《World Journal of Gastroenterology》 SCIE CAS 2010年第16期2055-2060,共6页
AIM:To investigate the prognostic impact of metastatic lymph node ratio(rN) on gastric cancer after curative distal gastrectomy.METHODS:A total of 634 gastric cancer patients who underwent curative resection(R0) of ly... AIM:To investigate the prognostic impact of metastatic lymph node ratio(rN) on gastric cancer after curative distal gastrectomy.METHODS:A total of 634 gastric cancer patients who underwent curative resection(R0) of lymph nodes at distal gastrectomy in 1995-2004.Correlations between positive nodes and retrieved nodes,between rN and retrieved nodes,and between rN and negative lymph node(LN) count were analyzed respectively.Prognostic factors were identif ied by univariate and multivariate analyses.Staging accuracy of the pN category(5th UICC/TNM system) and the rN category was compared according to the survival rates of patients.A linear regression model was used to identify the relation between rN and 5-year survival rate of the patients.RESULTS:The number of dissected LNs was related with metastatic LNs but not related with rN.Cox regression analysis showed that depth of invasion,pN and rN category were the independent predictors of survival(P 0.05).Linear regression model showed a signif icant linear correlation between rN and the 5-year survival rate of gastric cancer patients(β = 0.862,P < 0.001).Pearson's correlation test revealed that negative LN count was negatively correlated with rN(P < 0.001).CONCLUSION:rN category is a better prognostic tool than the 5th UICC pN category for gastric cancer patients after curative distal gastrectomy.Increased negative LN count can reduce rN and improve the survival rate of gastric cancer patients. 展开更多
关键词 Stomach neoplasm Gastrectomy Lymphadenectomy Metastatic lymph node ratio Prognosis
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Effect of the number of positive lymph nodes and lymph node ratio on prognosis of patients after resection of pancreatic adenocarcinoma 认领 引用 被引量：6
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作者 Zu-Qiang Liu Zhi-Wen Xiao +6 位作者 Guo-Pei Luo Liang Liu Chen Liu Jin Xu Jiang Long Quan-Xing Ni Xian-Jun Yu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2014年第6期634-641,共8页
BACKGROUND： The prognostic factors related to lymph node involvement [lymph node status, the number of positive lymph nodes, lymph node ratio （LNR）] and the number of nodes evaluated in patients with pancreatic ade... BACKGROUND： The prognostic factors related to lymph node involvement [lymph node status, the number of positive lymph nodes, lymph node ratio （LNR）] and the number of nodes evaluated in patients with pancreatic adenocarcinoma after pancreatectomy are poorly defined. METHODS： A total of 167 patients who had undergone resection of pancreatic adenocarcinoma from February 2010 to August 2011 were included in this study. Histological examination was performed to evaluate the tumor differentiation and lymph node involvement. Univariate and multivariate analyses were made to determine the relationship between the variables related to nodal involvement and the number of nodes and survival. RESULTS： The median number of total nodes examined was 10 （range 0-44） for the entire cohort. The median number of total nodes examined in node-negative （pN0） patients was similar to that in node-positive （pN1） patients. Patients with pN1 diseases had significantly worse survival than those with pN0 ones （P=0.000）. Patients with three or more positive nodes had a poorer prognosis compared with those with the negative nodes （P=0.000）. The prognosis of the patients with negative nodes was similar to that of those with one to two positive nodes （P=0.114）. The median survival of patients with an LNR ≥0.4 was shorter than that of patients with an LNR 〈0.4 in the pN1 cohort （P=0.014）. No significance was found between the number of total nodes examined and the prognosis, regardless of the cutoff of 10 or 12 and in the entire cohort or the pN0 and pN1 groups. Based on the multivariate analysis of the entire cohort and the pN1 group, the nodal status, the number of positive nodes and the LNR were all associated with survival. CONCLUSIONS： In addition to the nodal status, the number of positive nodes and the LNR can serve as comprehensive factors for the evaluation of nodal involvement. This approach may be more effective for predicting the survival of patients with pancreatic adenocarcinoma after pancreatectomy. 展开更多
关键词 lymph node status lymph node ratio number of positive nodes number of total nodes examined pancreatic adenocarcinoma pancreatectomy
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Neoadjuvant chemoradiation is associated with decreased lymph node ratio in borderline resectable pancreatic cancer:A propensity score matched analysis 认领 引用
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作者 June S Peng Gareth Morris-Stiff +4 位作者 Noaman S Ali Jane Wey Sricharan Chalikonda Kevin M El-Hayek R Matthew Walsh 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2021年第1期74-79,共6页
Background:Lymph node ratio(LNR)and margin status have prognostic significance in pancreatic cancer.Herein we examined the pathologic and clinical outcomes in patients with borderline resectable pancreatic cancer(BRPC... Background:Lymph node ratio(LNR)and margin status have prognostic significance in pancreatic cancer.Herein we examined the pathologic and clinical outcomes in patients with borderline resectable pancreatic cancer(BRPC)following neoadjuvant therapy(NAT)and pancreaticoduodenectomy.Methods:Patients who underwent treatment between January 1,2012 and June 30,2017 were included.Sequential patients in the BRPC group were compared to a propensity score matched cohort of patients with radiographically resectable pancreatic cancer who underwent upfront surgical resection.The BRPC group was also compared to sequential patients with radiographically resectable pancreatic cancer who required vein resection(VR)during upfront surgery.Results:There were 50 patients in the BRPC group,50 patients in the matched control group,and 38 patients in the VR group.Negative margins(R0)were seen in 72%,64%,and 34%of the BRPC,control,and VR groups,respectively(P=0.521 for BRPC vs.control;P=0.002 for BRPC vs.VR),with 24%of the BRPC group requiring a vascular resection.Nodal stage was N0 in 64%,20%,and 18%of the BRPC,control,and VR groups,respectively(P<0.001 for BRPC vs.control or VR).When nodal status was stratified into four groups(N0,or LNR≤0.2,0.2–0.4,≥0.4),the BRPC group had a more favorable distribution(P<0.001).The median overall survival were 28.8,38.6,and 19.0 months for the BRPC,control,and VR groups,respectively(log-rank P=0.096).Conclusions:NAT in BRPC was associated with more R0 and N0 resections and lower LNR compared to patients undergoing upfront resection for resectable disease. 展开更多
关键词 Neoadjuvant therapy Lymph node ratio Pancreatic cancer Borderline resectable Vein resection
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Prognostic value of lymph node ratio in hypopharyngeal squamous cell carcinoma after chemoradiotherapy 认领 引用 被引量：1
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作者 Yu Yue Wang Xiao-lei +2 位作者 Xu Zhen-gang Fan Cheng-cheng Li Qing 《Chinese Medical Journal》 SCIE CAS CSCD 2013年第21期4139-4144,共6页
Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell ca... Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell carcinoma （HPSCC） after neoadjuvant therapy in our institution. 展开更多
关键词 hypopharyngeal neoplasms neck dissection survival analysis lymphatic metastasis lymph node ratio
The value of the lymph node ratio and total number of lymph nodes examined for resected pancreatic signet ring cell carcinoma:a retrospective cohort study 认领 引用
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作者 Chao Ren Feng Xue +1 位作者 Yinying Wu Zheng Wang 《Journal of Pancreatology》 2022年第2期87-95,共9页
Background:Pancreatic signet ring cell carcinoma(SRCC)is an exceedingly rare histological subtype of pancreatic cancer.Previous studies have focused on the trends of incidence and independent predictors of pancreatic ... Background:Pancreatic signet ring cell carcinoma(SRCC)is an exceedingly rare histological subtype of pancreatic cancer.Previous studies have focused on the trends of incidence and independent predictors of pancreatic SRCC.Our objectives of the study were to analyze the prognostic value of the lymph node ratio(LNR)and to explore the minimal number of lymph nodes examined to accurately evaluate the N stage in resected pancreatic SRCC.Method:We analyzed 120 patients diagnosed from January 1,1990,to December 31,2016,constituted the study cohort from the Surveillance,Epidemiology,and End Results(SEER)registry.We calculated the overall survival(OS)of these patients by using a Kaplan–Meier analysis.The Kaplan–Meier analysis was used to analyze the influence of various factors on the prognosis of patients in the univariate analysis.The multivariate Cox analysis were applied to find independent prognostic factors of patients with pancreatic SRCC.Receiver-operating characteristic curve(ROC)analysis to investigate the discriminatory ability of the total number of lymph nodes examined(TNLE)relative to whether lymph node metastasis was present.Results:The median number of lymph nodes examined among 120 patients with resected pancreatic SRCC was 14(interquartile range:6.25–20.0).According to the univariate analysis of OS,age,grade,chemotherapy,LNR,and TNLE were significantly different(P<.05).We demonstrated the prognostic benefit of chemotherapy in resected pancreatic SRCC,whereas radiotherapy was not associated with improved survival.The multivariate survival analysis showed that LNR and grade were independent prognostic indicators after pancreatic SRCC resection for OS.TNLE≥8 showed the highest discriminatory power for evaluating lymph node metastasis(Area under curve(AUC):0.656,95%confidence interval:0.564–0.741,Youden index:0.2533,sensitivity:78.67%,specificity:46.67%,P=.003).Conclusion:Our study indicated that the LNR was a valuable independent prognostic factor for resected pancreatic SRCC.Regional lymphadenectomy of at least 8 lymph nodes was necessary to accurately stage patients.An adequate number of lymph nodes examined are necessary for clinicians to accurately predict the significance of the LNR in resected pancreatic SRCC. 展开更多
关键词 Independent factor Lymph node ratio Pancreatic signet ring cell carcinoma SEER database Total number of lymph nodes examined
Lymph node ratio in resected pancreatic head cancers: time for a broader clinical implementation? 认领 引用
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作者 Ernesto Sparrelid Poya Ghorbani Marcus Holmberg 《Hepatobiliary Surgery and Nutrition》 SCIE 2024年第2期374-375,共2页
Lymph node ratio(LNR)has emerged as a promising predictor for survival outcome after surgery in different tumor types(1,2).The concept of evaluating LNR as a prognostic factor also after pancreatic surgery has been de... Lymph node ratio(LNR)has emerged as a promising predictor for survival outcome after surgery in different tumor types(1,2).The concept of evaluating LNR as a prognostic factor also after pancreatic surgery has been described in several publications(3,4).Most of the previous reports on LNR in this setting are single-center studies with rather small cohorts and/or mixed histological tumor types,possibly limiting the generalizability of the results.Even if the role of LNR in pancreatic cancer has been acknowledged,it is still regarded as having mostly academical implications when comparing results from different studies and is probably rarely being used as a tool in clinical decision-making world-wide. 展开更多
关键词 Pancreas cancer surgery lymph node ratio(LNR)
Evaluation of three lymph node staging systems for prognostic prediction in gastric cancer:A systematic review and meta-analysis 认领 引用
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作者 Ming Cheng Yang Yu +8 位作者 Takehiro Watanabe Yutaro Yoshimoto Sanae Kaji Yukinori Yube Munehisa Kaneda Hajime Orita Shinji Mine You-Yong Wu Tetsu Fukunaga 《World Journal of Gastrointestinal Oncology》 SCIE 2025年第3期334-348,共15页
BACKGROUND Lymph node status is a critical prognostic factor in gastric cancer(GC),but stage migration may occur in pathological lymph nodes(pN)staging.To address this,alternative staging systems such as the positive ... BACKGROUND Lymph node status is a critical prognostic factor in gastric cancer(GC),but stage migration may occur in pathological lymph nodes(pN)staging.To address this,alternative staging systems such as the positive lymph node ratio(LNR)and log odds of positive lymph nodes(LODDS)were introduced.AIM To assess the prognostic accuracy and stratification efficacy of three nodal staging systems in GC.METHODS A systematic review identified 12 studies,from which hazard ratios(HRs)for overall survival(OS)were summarized.Sensitivity analyses,subgroup analyses,publication bias assessments,and quality evaluations were conducted.To enhance comparability,data from studies with identical cutoff values for pN,LNR,and LODDS were pooled.Homogeneous stratification was then applied to generate Kaplan-Meier(KM)survival curves,assessing the stratification efficacy of three staging systems.RESULTS The HRs and 95%confidence intervals for pN,LNR,and LODDS were 2.16(1.72-2.73),2.05(1.65-2.55),and 3.15(2.15-4.37),respectively,confirming all three as independent prognostic risk factors for OS.Comparative analysis of HRs demonstrated that LODDS had superior prognostic predictive power over LNR and pN.KM curves for pN(N0,N1,N2,N3a,N3b),LNR(0.1/0.2/0.5),and LODDS(-1.5/-1.0/-0.5/0)revealed significant differences(P<0.001)among all prognostic stratifications.Mean differences and standard deviations in 60-month relative survival were 27.93%±0.29%,41.70%±0.30%,and 26.60%±0.28%for pN,LNR,and LODDS,respectively.CONCLUSION All three staging systems are independent prognostic factors for OS.LODDS demonstrated the highest specificity,making it especially useful for predicting outcomes,while pN was the most effective in homogeneous stratification,offering better patient differentiation.These findings highlight the complementary roles of LODDS and pN in enhancing prognostic accuracy and stratification. 展开更多
关键词 Gastric cancer Prognostic predictor Overall survival Meta-analysis Pathological lymph nodes Positive lymph node ratio Log odds of positive lymph nodes
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Colorectal cancer and lymph nodes:The obsession with the number 12 认领 引用 被引量：6
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作者 Giovanni Li Destri Isidoro Di Carlo +2 位作者 Roberto Scilletta Beniamino Scilletta Stefano Puleo 《World Journal of Gastroenterology》 SCIE CAS 2014年第8期1951-1960,共10页
Lymphadenectomy of colorectal cancer is a decisive factor for the prognostic and therapeutic staging of the patient. For over 15 years, we have asked ourselves if the minimum number of 12 examined lymph nodes (LNs) wa... Lymphadenectomy of colorectal cancer is a decisive factor for the prognostic and therapeutic staging of the patient. For over 15 years, we have asked ourselves if the minimum number of 12 examined lymph nodes (LNs) was sufficient for the prevention of understaging. The debate is certainly still open if we consider that a limit of 12 LNs is still not the gold standard mainly because the research methodology of the first studies has been criticized. Moreover many authors report that to date both in the United States and Europe the number &#x0201c;12&#x0201d; target is uncommon, not adequate, or accessible only in highly specialised centres. It should however be noted that both the pressing nature of the debate and the dissemination of guidelines have been responsible for a trend that has allowed for a general increase in the number of LNs examined. There are different variables that can affect the retrieval of LNs. Some, like the surgeon, the surgery, and the pathology exam, are without question modifiable; however, other both patient and disease-related variables are non-modifiable and pose the question of whether the minimum number of examined LNs must be individually assigned. The lymph nodal ratio, the sentinel LNs and the study of the biological aspects of the tumor could find valid application in this field in the near future. 展开更多
关键词 Colorectal cancer Lymphadenectomy Lymph node count Lymph node ratio Staging
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Different lymph node staging systems for predicting the prognosis of colorectal neuroendocrine neoplasms 认领 引用
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作者 Yuan-Yi Zhang Yue-Wei Cai Xia Zhang 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第5期1745-1755,共11页
BACKGROUND Colorectal neuroendocrine neoplasms(NENs)are a rare malignancy that primarily arises from the diffuse distribution of neuroendocrine cells in the colon and rectum.Previous studies have pointed out that the ... BACKGROUND Colorectal neuroendocrine neoplasms(NENs)are a rare malignancy that primarily arises from the diffuse distribution of neuroendocrine cells in the colon and rectum.Previous studies have pointed out that the status of lymph node may be used to predict the prognosis.AIM To investigate the predictive values of lymph node ratio(LNR),positive lymph node(PLN),and log odds of PLNs(LODDS)staging systems on the prognosis of colorectal NENs treated surgically,and compare their predictive values.METHODS This cohort study included 895 patients with colorectal NENs treated surgically from the Surveillance,Epidemiology,and End Results database.The endpoint was mortality of patients with colorectal NENs treated surgically.X-tile software was utilized to identify most suitable thresholds for categorizing the LNR,PLN,and LODDS.Participants were selected in a random manner to form training and testing sets.The prognosis of surgically treating colorectal NENs was examined using multivariate cox analysis to assess the associations of LNR,PLN,and LODDS with the prognosis of colorectal NENs.C-index was used for assessing the predictive effectiveness.We conducted a subgroup analysis to explore the different lymph node staging systems’predictive values.RESULTS After adjusting all confounding factors,PLN,LNR and LODDS staging systems were linked with mortality in patients with colorectal NENs treated surgically(P<0.05).We found that LODDS staging had a higher prognostic value for patients with colorectal NENs treated surgically than PLN and LNR staging systems.Similar results were obtained in the different G staging subgroup analyses.Furthermore,the area under the receiver operating characteristic curve values for LODDS staging system remained consistently higher than those of PLN or LNR,even at the 1-,2-,3-,4-,5-and 6-year follow-up periods.CONCLUSION LNR,PLN,and LODDS were found to significantly predict the prognosis of patients with colorectal NENs treated surgically. 展开更多
关键词 Positive lymph node Lymph node ratio Log odds of positive lymph nodes Prognosis Colorectal neuroendocrine neoplasms
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Prognostic impact of number of examined lymph nodes on survival of patients with appendiceal neuroendocrine tumors 认领 引用
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作者 Rui Du Jiang-Wei Xiao 《World Journal of Clinical Cases》 SCIE 2022年第30期10906-10920,共15页
BACKGROUND The prognosis of patients with appendiceal neuroendocrine tumors(ANETs) is related to lymph node(LN) metastasis and other factors.However,it is unclear how the number of examined LNs(ELNs) impact on surviva... BACKGROUND The prognosis of patients with appendiceal neuroendocrine tumors(ANETs) is related to lymph node(LN) metastasis and other factors.However,it is unclear how the number of examined LNs(ELNs) impact on survival.AIM To determine the factors affecting the cancer-specific survival(CSS) of patients with ANET and to evaluate the impact of the number of ELNs on survival.METHODS A total of 4583 ANET patients were analyzed in the Surveillance,Epidemiology,and End Results database.Univariate survival analysis was used to identify factors related to survival and the optimal number of ELNs and lymph node ratio(LNR) were determined by the Kaplan–Meier method.The survival difference was determined by CSS.RESULTS Except for sex,the other factors,such as age,year,race,grade,histological type,stage,tumor size,ELNs,LNR,and surgery type,were associated with prognosis.The 3-,5-,and 10-year CSS rates of ANET patients were 91.2%,87.5,and 81.7%,respectively(median follow-up period of 31 mo and range of 0-499 mo).There was no survival difference between the two surgery types,namely,local resection and colectomy or greater,in both stratifications of tumor size ≥ 2 cm(P = 0.523)and < 2 cm(P = 0.068).In contrast to patients with a tumor size < 2 cm,those with a tumor size ≥ 2 cm were more likely to have LN metastasis(χ~2 = 378.16,P < 0.001).The optimal number of ELNs was more than 11,7,and 18 for all patients,nodenegative patients,and node-positive patients,respectively.CSS rates of patients with a larger number of ELNs were significantly improved(≤ 10 vs ≥ 11,χ~2 =20.303,P < 0.001;≤ 6 vs ≥ 7,χ~2 = 11.569,P < 0.001;≤ 17 vs ≥ 18,χ~2 = 21.990,P < 0.001;respectively).ANET patients with an LNR value ≤ 0.16 were more likely to have better survival than those with values of 0.17-0.48(χ~2 = 48.243,P < 0.001) and 0.49-1(χ~2 = 168.485,P < 0.001).CONCLUSION ANET ≥ 2 cm are more likely to develop LN metastasis.At least 11 ELNs are required to better evaluate the prognosis.For patients with positive LN metastasis,18 or more LNs need to be detected and lower LNR values(LNR ≤ 0.16) indicate a better survival prognosis. 展开更多
关键词 Appendiceal neoplasm Neuroendocrine tumors Carcinoid tumor Lymph node dissection Lymph node ratio Survival analysis
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CEA、AFP、NLR联合磁共振参数对早期胃癌淋巴结转移的预测价值 认领 引用
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作者 余森源 马洪林 +3 位作者 王教学 严和中 侯曦露 贺星 《影像科学与光化学》 CAS 2026年第5期82-88,114,共7页
目的:研究癌胚抗原(CEA)、甲胎蛋白(AFP)、中性粒细胞与淋巴细胞比值(NLR)及表观扩散系数(ADC)在预测早期胃癌淋巴结转移中的应用价值。方法:分析2023年10月至2024年12月期间108例确诊为早期胃癌的病例,依据术后病理学结果分为转移组(35... 目的:研究癌胚抗原(CEA)、甲胎蛋白(AFP)、中性粒细胞与淋巴细胞比值(NLR)及表观扩散系数(ADC)在预测早期胃癌淋巴结转移中的应用价值。方法:分析2023年10月至2024年12月期间108例确诊为早期胃癌的病例,依据术后病理学结果分为转移组(35例)和非转移组(73例)。比较两组一般资料,以及CEA、AFP、NLR、ADC的差异。淋巴结转移的危险因素使用Logistic多因素回归方程分析,构建列线图模型并进行评价。结果:转移组CEA(31.82±3.28)ng/mL、AFP(12.76±2.49)ng/mL、NLR(2.64±0.53)更高,ADC(0.73±0.12)×10-3mm2/s更小(P10%时,使用该模型有较高的临床收益。结论:早期胃癌患者淋巴结转移风险因素为CEA、AFP、NLR、ADC,以上指标构建的列线图模型可为临床医疗决策提供依据。 展开更多
关键词 癌胚抗原 甲胎蛋白 中性粒细胞/淋巴细胞比值 表观扩散系数 早期胃癌 淋巴结转移 预测
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MLR、FAR、PLR联合临床特征对胃癌患者淋巴结转移的预测价值 认领 引用
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作者 蒙丽覃 黄鑫 +2 位作者 闭金丽 李婧涵 李泰阶 《检验医学与临床》 CAS 2026年第5期679-685,共7页
目的构建单核细胞计数/淋巴细胞计数比值(MLR)、纤维蛋白原/清蛋白比值(FAR)与血小板/淋巴细胞比值(PLR)联合临床特征对胃癌患者淋巴结转移的预测模型,并验证其预测价值。方法选取2020年6月至2023年10月广西医科大学第一附属医院收治的... 目的构建单核细胞计数/淋巴细胞计数比值(MLR)、纤维蛋白原/清蛋白比值(FAR)与血小板/淋巴细胞比值(PLR)联合临床特征对胃癌患者淋巴结转移的预测模型,并验证其预测价值。方法选取2020年6月至2023年10月广西医科大学第一附属医院收治的600例胃癌患者作为研究对象。根据是否存在淋巴结转移将患者分为转移组与非转移组。收集所有研究对象临床资料,包括性别、年龄、民族、血型、肿瘤位置、分化程度、肿瘤最大径、T分期、M分期和美国癌症联合委员会癌症分期系统(AJCC)分级、血液学指标[中性粒细胞/淋巴细胞比值(NLR)、PLR、MLR、FAR、营养指数(PNI)]。采用多因素Logistic回归分析胃癌患者发生淋巴结转移的影响因素。绘制受试者工作特征(ROC)曲线分析NLR、PLR、MLR、FAR、PNI预测胃癌患者淋巴结转移的价值,并验证回归模型预测胃癌患者淋巴结转移的价值。对回归模型进行Bootstrap内部验证及决策曲线分析。结果转移组纳入417例,非转移组纳入183例。转移组与非转移组肿瘤位置、分化程度、肿瘤最大径、T分期、M分期、AJCC分级、NLR、PLR、MLR、FAR、PNI比较,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,NLR、PLR、MLR、FAR和PNI诊断胃癌淋巴结转移的最佳截断值分别为2.11、144.38、0.27、0.10和45.08。多因素Logistic回归分析结果显示,PLR、MLR、FAR、T分期升高是胃癌患者发生淋巴结转移的独立危险因素(P<0.05)。ROC曲线验证结果显示,回归模型预测胃癌淋巴结转移的曲线下面积为0.809。Bootstrap验证显示模型具有良好的稳健性,决策曲线提示联合模型在临床应用中获益最高。结论MLR、FAR和PLR均为胃癌患者淋巴结转移的独立预测指标,其联合使用能提高预测效能。进一步结合T分期构建的联合模型具有较高的区分度和临床应用价值,有望作为简便、经济的术前风险评估工具,为临床决策提供参考。 展开更多
关键词 胃癌 淋巴结转移 单核细胞计数/淋巴细胞计数比值 纤维蛋白原/清蛋白比值 血小板/淋巴细胞比值
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术前外周血NLR、FAR与甲状腺乳头状癌中央区淋巴结转移的关系 认领 引用
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作者 张辉 华江伟 +1 位作者 胡杨丽 马荟 《检验医学与临床》 CAS 2026年第12期1611-1616,共6页
目的探讨术前外周血中性粒细胞/淋巴细胞比值(NLR)、纤维蛋白原/清蛋白比值(FAR)与甲状腺乳头状癌(PTC)患者发生中央区淋巴结转移(CLNM)的关系。方法选取2022年1月至2024年12月该院收治的278例PTC患者作为研究对象,根据术后是否发生CLN... 目的探讨术前外周血中性粒细胞/淋巴细胞比值(NLR)、纤维蛋白原/清蛋白比值(FAR)与甲状腺乳头状癌(PTC)患者发生中央区淋巴结转移(CLNM)的关系。方法选取2022年1月至2024年12月该院收治的278例PTC患者作为研究对象,根据术后是否发生CLNM分为转移组与未转移组。比较2组基线资料及术前外周血NLR、FAR。采用多因素Logistic回归分析PTC患者发生CLNM的影响因素,采用平滑拟合曲线分析外周血NLR、FAR与PTC患者发生CLNM的关系,并采用受试者工作特征(ROC)曲线评估术前外周血NLR、FAR联合预测PTC患者发生CLNM的价值。结果转移组年龄1 cm、有包膜侵犯及有甲状腺外侵犯的比例均高于未转移组,差异均有统计学意义(P0.05)。ROC曲线分析结果显示,术前外周血NLR、FAR联合预测PTC患者发生CLNM的曲线下面积(AUC)为0.860(95%CI:0.814~0.899),明显大于NLR、FAR单独预测的AUC(Z=2.717、2.809,均P<0.05)。结论术前外周血NLR、FAR是PTC患者发生CLNM的独立影响因素,联合检测对发生CLNM具有一定预测价值,二者可作为预测CLNM的辅助指标,从而为临床决策提供参考。 展开更多
关键词 甲状腺乳头状癌 中性粒细胞/淋巴细胞比值 纤维蛋白原/清蛋白比值 中央区淋巴结转移 预测价值
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中性粒细胞与血小板比值在腮腺恶性肿瘤中的诊断价值 认领 引用
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作者 薛星月 曹焜 +3 位作者 卢芳 鲍强 孙玉华 李家锋 《中国口腔颌面外科杂志》 CAS 2026年第1期23-27,共5页
目的:探讨术前中性粒细胞与血小板比值(NPR)在腮腺恶性肿瘤中的诊断价值,分析其与肿瘤分期及淋巴结转移的相关性。方法:选择2022年10月—2024年10月徐州医科大学附属医院收治的腮腺肿瘤患者248例,其中恶性肿瘤组(试验组)124例,良性肿瘤... 目的:探讨术前中性粒细胞与血小板比值(NPR)在腮腺恶性肿瘤中的诊断价值,分析其与肿瘤分期及淋巴结转移的相关性。方法:选择2022年10月—2024年10月徐州医科大学附属医院收治的腮腺肿瘤患者248例,其中恶性肿瘤组(试验组)124例,良性肿瘤组(对照组)124例。比较两组患者术前外周血NPR、中性粒细胞与淋巴细胞比值(NLR)、全身炎症反应指数(SIRI)等炎症指标,通过logistic回归分析筛选腮腺恶性肿瘤的独立危险因素,采用受试者工作特征(ROC)曲线评估NPR的诊断效能。结果:试验组NPR水平显著高于对照组(P<0.001)。多因素logistic回归显示,NPR是腮腺恶性肿瘤的独立危险因素(OR=1.055,95%CI:1.007~1.104,P=0.022)。试验组中,淋巴结转移组NPR显著高于非转移组(P<0.001),晚期组(Ⅲ+Ⅳ期)显著高于早期组(Ⅰ+Ⅱ期)(P<0.05)。ROC曲线显示,NPR诊断腮腺恶性肿瘤的曲线下面积(AUC)为0.663(95%CI:0.587~0.739),在最佳临界值0.014时,敏感度为68.8%,特异度为58.3%。结论:术前外周静脉血NPR水平可作为腮腺恶性肿瘤的辅助诊断指标,高NPR提示肿瘤恶性风险高、分期晚且淋巴结转移可能性大,但其诊断效能有限,需结合临床检查综合判断。 展开更多
关键词 腮腺恶性肿瘤 中性粒细胞与血小板比值 炎症反应 诊断价值 淋巴结转移
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PLT、NLR、PLR、甲状腺功能相关指标与DTC颈部淋巴结转移的关系及预测模型构建 认领 引用
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作者 王春燕 周兰柱 《中华全科医学》 2026年第3期415-419,共5页
目的分析血小板计数(PLT)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、甲状腺功能相关指标与分化型甲状腺癌(DTC)合并颈部淋巴结转移的关系,为优化DTC合并颈部淋巴结转移患者的诊疗策略提供参考。方法选取2020年1月—2... 目的分析血小板计数(PLT)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、甲状腺功能相关指标与分化型甲状腺癌(DTC)合并颈部淋巴结转移的关系,为优化DTC合并颈部淋巴结转移患者的诊疗策略提供参考。方法选取2020年1月—2024年1月蚌埠医科大学第一附属医院收治的221例DTC患者,依据是否合并颈部淋巴结转移分为发生组(78例)和未发生组(143例)。比较2组PLR、NLR、PLR、甲状腺功能相关指标差异。采用多因素logistic回归分析研究DTC合并颈部淋巴结转移的影响因素。绘制ROC曲线,评估各独立危险因素单独及联合应用对DTC合并颈部淋巴结转移的预测效能。结果发生组临床分期Ⅱ期占比、PLT、NLR、PLR、促甲状腺激素(TSH)、甲状腺球蛋白(Tg)均高于未发生组(P<0.05)。二元logistic回归分析显示,临床分期、PLT、NLR、PLR、TSH、Tg均是DTC合并颈部淋巴结转移的独立影响因素(P<0.05)。建立DTC合并颈部淋巴结转移的列线图风险预测模型,ROC分析显示,临床分期、PLT、NLR、PLR、TSH、Tg、列线图风险预测模型的曲线下面积分别为0.573、0.720、0.613、0.738、0.751、0.718、0.898。结论临床分期Ⅱ期及PLT、NLR、PLR、TSH、Tg升高为DTC合并颈部淋巴结转移的独立危险因素,基于此构建的列线图预测模型具有高预测效能与临床实用性。 展开更多
关键词 分化型甲状腺癌 血小板计数 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 甲状腺功能 淋巴结转移 列线图
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Phenotypic attributes and survival in mismatch repair deficient/microsatellite instability-high colorectal carcinomas 认领 引用
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作者 Anurag Mehta Divya Bansal +1 位作者 Rupal Tripathi Vidya Anoop 《World Journal of Clinical Oncology》 2025年第6期207-217,共11页
BACKGROUND Mismatch repair deficient/microsatellite instability-high(MMR-D/MSI-H)colorectal cancers(CRCs)possess a distinctive genomic profile that results in a spectrum of phenotypic attributes setting them apart fro... BACKGROUND Mismatch repair deficient/microsatellite instability-high(MMR-D/MSI-H)colorectal cancers(CRCs)possess a distinctive genomic profile that results in a spectrum of phenotypic attributes setting them apart from their mismatch repair proficient(MMR-P)or microsatellite stable(MSS)counterparts.CRCs have several prognostic factors,including stage,tumor differentiation,location,lymphovascular and perineural invasion,tumor budding,tumor infiltrating lymphocytes,lymph node yield(LNY),and lymph node ratio(LNR).AIM To determine the unique phenotypic characteristics of MMR-D/MSI-H CRCs and leverage the conventional wisdom of LNY and LNR with the distinctive characteristics of MMR-D/MSI-H CRCs.METHODS This retrospective analysis involved 223 stage I-III CRC patients who underwent surgical resection without neoadjuvant treatment.Clinical and histological features were obtained from patient records and by re-examining the hematoxylin and eosin-stained slides.MMR/MSI status was evaluated for all patients using either MMR immunohistochemistry or MSI testing.RESULTS Of the 223 patients in our study,87(39.01%)were MMR-D/MSI-H CRCs while 136(60.99%)were MMR-P/MSS CRCs.The MMR-D/MSI-H CRCs exhibited significant statistical differences compared to the MMR-P/MSS CRCs in several factors,including location,stage,tumor budding,lymphovascular and perineural invasion,lymphocytic response,LNY,LNR,and size of uninvolved lymph nodes.LNY and LNR were significantly higher in MMR-D/MSI-H group compared with the MMR-P/MSS group(P=0.003 and P<0.001,respectively).Also,the interquartile range of the largest uninvolved lymph node was 1 cm(0.8 cm-1.2 cm)in MMR-D/MSI-H CRCs compared to 0.7 cm(0.6 cm-0.97 cm)in MMRP/MSS CRCs.The overall survival for the MMR-P/MSS CRC group was 71%at five years,and the MMR-D/MSIH CRC group was 92%at five years(P<0.001).CONCLUSION MMR-D/MSI-H CRCs possess a unique genomic profile that leads to distinct phenotypic characteristics,including an enhanced immune response.This distinctive profile underscores the substantial prognostic and predictive value of MMR-D/MSI-H status in CRC. 展开更多
关键词 Mismatch repair Microsatellite instability Lymph node yield Lymph node ratio Colorectal carcinoma
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