Lymph Node Count and Ratio in Assessment of Colon Cancer Surgery

Wenli Chen
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Abstract

Objective: The purpose of this study was to evaluate the application of lymph node count (LNC) and lymph node ratio (LNR) in the surgical prognostic assessment of colon cancer. Methods: To analyze the correlation among LNC, LNR, and clinicopathological features including systemic inflammatory response (SIR) in patients undergoing colon cancer surgery. To provide a new evaluation idea for clinicians to evaluate the prognosis of colon cancer surgery. The methods of this study was to retrospectively analyze the clinical data of patients who underwent colon cancer resection at the Affiliated Bozhou Hospital of Anhui Medical University from August 1, 2013 to August 1, 2023. LNC (<12 / ≥12) and LNR (<0.25 / ≥0.25) were analyzed using Chi-square test and logistic regression, as well as clinicopathological characteristics including modified Glasgow Prognostic Score, C-reactive protein and albumin, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio, and lymphocyte to monocyte ratio. Univariate and multifactorial analyses were performed to analyze the relationship between LNR (<0.25 / ≥0.25) and clinicopathological characteristics and LNC≥12. Results: In multifactorial analysis, significant differences were found between T stage, N stage, LNR (≥0.25), luminal / open, and COPD (P<0.05). Among patients with LNC≥12 and positive lymph nodes, multivariate analysis showed that elevated LNR (≥0.25) was linked to T stage, NLR, and peritoneal invasion. Conclusion: LNC and LNR were unrelated with SIR labeling. The LNC and LNR, on the reverse hand, are directly related. In quality surgical and pathologic practice, when compared to N stage, LNR offers a better prognostic value for patients having surgery for colon cancer.The findings of this study demonstrate that LNR is dependent on LNC and has prognostic value in colon cancer patients.
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结肠癌手术中淋巴结计数及比值的评价
目的:探讨淋巴结计数(LNC)和淋巴结比例(LNR)在结肠癌手术预后评估中的应用价值。方法:分析结肠癌手术患者LNC、LNR与全身炎症反应(SIR)等临床病理特征的相关性。为临床医生评价结肠癌手术预后提供一种新的评价思路。本研究方法回顾性分析2013年8月1日至2023年8月1日在安徽医科大学附属亳州医院行结肠癌切除术患者的临床资料。采用卡方检验和logistic回归分析LNC (<12 /≥12)和LNR (<0.25 /≥0.25),以及改良格拉斯哥预后评分、c反应蛋白和白蛋白、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值、淋巴细胞与单核细胞比值等临床病理特征。采用单因素和多因素分析分析LNR (<0.25 /≥0.25)与临床病理特征及LNC≥12的关系。结果:在多因素分析中,T期、N期、LNR(≥0.25)、luminal / open和COPD之间存在显著性差异(P<0.05)。在LNC≥12且淋巴结阳性的患者中,多因素分析显示,LNR升高(≥0.25)与T分期、NLR和腹膜浸润有关。结论:LNC、LNR与SIR标记无关。相反,LNC和LNR是直接相关的。在高质量的外科和病理实践中,与N期相比,LNR对结肠癌手术患者的预后有更好的价值。本研究结果表明LNR依赖于LNC,在结肠癌患者中具有预后价值。
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