目的:确定患者相关因素与组织病理学因素之间的关系,以及国家结肠癌诊断和治疗计划和淋巴结产量(LNY)≥12的影响。
方法:在2003-2011年期间,对通过I-III期结肠癌根治性切除术治疗的全国性丹麦队列中的LNY进行了分析。LNY≥12岁与年龄之间的关联,性别,身体质量指数,开放式vs.腹腔镜手术,急性vs.选择性手术,pT阶段,分析了肿瘤子部位和诊断年份。
结果:共有13,766名患者符合分析条件。总的来说,71.4%的患者LNY≥12。在多变量分析中,年龄,pT阶段,肿瘤亚部位和手术优先级与LNY≥12的概率独立相关.赔率(ORs)如下:年龄<651,65-750.685(置信区间(CI)0.586-0.800),>750.517(CI0.439-0.609);T11,T22.750(CI2.168-3.487),T36.016(CI4.879-7.418),T46.317(CI4.950-8.063);右半结肠1,左半结肠0.568(0.511-0.633);择期手术1,急性手术0.748(CI0.625-0.894)。此外,研究期间每增加一年,诊断年份与LNY≥12的概率相关:OR1.480(CI1.445~1.516).
结论:LNY≥12与年龄显著相关,pT阶段,肿瘤亚部位和手术优先级。在研究期间观察到LNY的显着增加,可能反映了丹麦结直肠癌组织发起的国家计划的效果。
OBJECTIVE: To determine the relation between patient-related and histopathological factors, as well as the influence of national programs for diagnosing and treatment of colon cancer and a lymph node yield (LNY) ≥ 12.
METHODS: An analysis was carried out of the LNY in a nationwide Danish cohort treated by curative resection of stage I-III colon cancer in the period 2003-2011. The association between a LNY ≥ 12 and age, sex, body mass index, open vs. laparoscopic surgery, acute vs. elective surgery, pT stage, tumour sub-site and year of diagnosis was analysed.
RESULTS: A total of 13,766 patients were eligible for the analysis. In total, 71.4 % of the patients had a LNY ≥ 12. In multivariate analysis, age, pT stage, tumour sub-site and priority of surgery were independently associated with the probability of a LNY ≥ 12. Odds ratios (ORs) were as follows: age <65 1, 65-75 0.685 (confidence interval (CI) 0.586-0.800), >75 0.517 (CI 0.439-0.609); T1 1, T2 2.750 (CI 2.168-3.487), T3 6.016 (CI 4.879-7.418), T4 6.317 (CI 4.950-8.063); right colon 1, left colon 0.568 (0.511-0.633); elective surgery 1, acute surgery 0.748 (CI 0.625-0.894). Moreover, year of diagnosis was associated with the probability of a LNY ≥ 12: OR 1.480 (CI 1.445-1.516) for each increasing year in the
study period.
CONCLUSIONS: A LNY ≥ 12 is significantly associated with age, pT stage, tumour sub-site and priority of surgery. A significant increase in the LNY over the period of the
study was observed, probably reflecting the effect of national programmes initiated by the Danish Colorectal Cancer Group.