[第六版与第七版TNM pT分类对胃癌预后预测价值的比较]

[Comparison of the predictive value of the sixth and seventh edition TNM pT classifications in prognosis for gastric cancer].

作者信息

Zhang Peng, Xu Yan, Guo Jiangning, Xu Humian

机构信息

Department of General Surgery, the 201st Hospital of PLA, Liaoyang 111000, China.

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出版信息

Zhonghua Zhong Liu Za Zhi. 2015 Mar;37(3):190-4.

PMID:25975787

Abstract

OBJECTIVE

To analyze the clinical application value of the 7th edition UICC-AJCC TNM pT classification of gastric cancer.

METHODS

The classification of tumor invasion depth of 874 cases of gastric cancer was determined using the 7th edition UICC-AJCC TNM classification and the relationships of prognosis with clinicopathological factors was compared with that obtained using the 6th edition TNM classification.

RESULTS

The 5-year survival rates according to the 6th edition pT1, pT2, pT3, pT4 were 98.4%, 55.8%, 26.0% and 24.5%, respectively, showing a significant difference among the four substages (P<0.001). The 5-year survival rates according to the 7th edition pT1a, pT1b, pT2, pT3, pT4a, and pT4b were 98.6%, 98.2%, 75.8%, 48.9%, 26.0% and 24.5%, respectively, and there were significant differences in survival time among the six substages (P<0.001). According to the 7th edition TNM classification, for the pT2 and pT3 patients groups, the 5-year survival rates of the 7th edition pN0 (without lymphatic metastasis) were 84.8% and 77.9%, respectively, showing no significant difference between the two survival rates (P=0.204). The 5-year survival rates according to the 7th edition pNx (with lymphatic metastasis) were 66.9% and 37.5%, respectively, and there was a significant difference between the two survival times (P<0.001). In multivariate analysis, the 7th edition pT stage, vascular or lymphatic invasion, the 6th edition pT staging and primary tumor site were independent prognostic factors in patients with gastric cancer (P<0.05), and the relationship of the staging of the 7th version of pT was more close with the prognosis of patients with gastric carcinoma than that of the 6th edition of pT staging system.

CONCLUSION

The 7th edition UICC-AJCC classification of pT staging of gastric cancer patients has a better prognostic predictive value than the 6th edition.

摘要

目的

分析第7版UICC-AJCC TNM pT分类在胃癌中的临床应用价值。

方法

采用第7版UICC-AJCC TNM分类法确定874例胃癌患者的肿瘤浸润深度，并将其预后与临床病理因素的关系与第6版TNM分类法所得结果进行比较。

结果

第6版pT1、pT2、pT3、pT4患者的5年生存率分别为98.4%、55.8%、26.0%和24.5%，四个亚阶段之间存在显著差异（P<0.001）。第7版pT1a、pT1b、pT2、pT3、pT4a和pT4b患者的5年生存率分别为98.6%、98.2%、75.8%、48.9%、26.0%和24.5%，六个亚阶段之间的生存时间存在显著差异（P<0.001）。根据第7版TNM分类，对于pT2和pT3患者组，第7版pN0（无淋巴结转移）的5年生存率分别为84.8%和77.9%，两者生存率无显著差异（P=0.204）。第7版pNx（有淋巴结转移）的5年生存率分别为66.9%和37.5%，两者生存时间存在显著差异（P<0.001）。多因素分析显示，第7版pT分期、血管或淋巴管侵犯、第6版pT分期和原发肿瘤部位是胃癌患者的独立预后因素（P<0.05），且第7版pT分期与胃癌患者预后的关系比第6版pT分期系统更密切。