Comparison Of The Prognostic Value Of Different Lymph Node Evaluation Methods For Stage Ⅲ Colorectal Cancer

Purpose:According to TNM staging,when clinicians evaluate the prognosis of patients with colorectal cancer,only the number of positive lymph nodes is used as a prognostic index related to the evaluation of patients’ lymph nodes.In order to explore the prognostic effects of postoperative lymph nodes,including positive lymph node ratio(LNR)and positive lymph node ratio logarithm(LODDS)have also been proposed.The purpose of this article is to evaluate the prognostic value of different lymph node staging methods for predicting stage Ⅲ CRC.Research method: The clinical data of 148 patients with stage III CRC who underwent radical surgery in Department of colorectal cancer,Shengjing Hospital,China Medical University from 2014 to 2015 were retrospectively analyzed.According to the clinical data and survival of patients,ROC curve was established to determine the best cut-off point of LNR and lodds,and patients were divided into groups;Kaplan Meier method was used for survival analysis of patients in different groups;univariate analysis was used to calculate and screen out the possible prognostic factors;multivariate proportional hazard regression model(Cox regression)was used to analyze the different influencing factors The prognosis of group A was analyzed.To compare the prognostic value of different lymph node evaluation methods for stage III CRC Results: Among the 148 patients,there were 101 patients who obtained all clinical data and followed up for more than 60 months.According to the ROC curve,the best cutoff values of LNR and LODDS are 0.127 and-0.79,and the area under the curve AUC is 0.809 and 0.793,respectively.According to the Youden index,the patients were divided into high LNR group and low LNR group,high LODDS group and low LODDS group.The survival analysis was carried out by Kaplan-Meier method,and it was concluded that the prognosis of low LNR group was significantly better than that of high LNR group.The prognosis of patients in the LODDS group was significantly better than that of the patients in the high LODDS group,and there was statistical significance(P<0.05).After univariate analysis,it is concluded that the depth of tumor invasion(T stage),regional lymph node metastasis(N stage),positive lymph node ratio(LNR group),and logarithm of positive lymph node ratio(LODDS group)are independent of the prognosis of stage III CRC.Risk factors.Based on multivariate analysis,N staging,LNR grouping and LODDS grouping are all meaningful for the prognosis of patients with stage Ⅲ CRC.Conclusion: 1.For this study,T staging,N staging,LNR grouping and LODDS grouping are independent risk factors for the prognosis of stage Ⅲ CRC.2.When the values of LNR and LODDS are 0.127 and-0.79,the patients are divided into groups,which can predict the prognosis of patients with stage III CRC.3.Multivariate analysis results suggest that: N staging,LNR grouping and LODDS grouping are all meaningful for the prognosis of patients with stage Ⅲ CRC.