Chang Shujian, Shi Xin, Xu Zhenyu, Liu Quan
Department of Oncology, The Affiliated Hospital of Jiangnan University (WUXI No. 4 Hospital), Wuxi 214062, Jiangsu Province, China.
J BUON. 2015 May-Jun;20(3):812-9.
To assess the survival predicting value of TNM, Lugano, and Ann Arbor staging systems in patients with primary gastrointestinal lymphoma (PGL).
101 patients with PGL were reviewed. All of them were staged according to TNM, Lugano, or Ann Arbor staging system. Five-year survival overall survival/OS rate was used as major clinical outcome. The prognostic value of different variables like depth of tumor infiltration (T), lymph node status (N), metastasis (M), sex, age, LDH, ECOG performance status (PS), subtypes, and tumor sites were assessed in relation to clinical outcome.
The median follow-up time was 46.6 months (range 1.3-158.6). The estimated 5-year OS rate was 74.22%. In gastric lymphoma ,the 5-year OS rate was well correlated with stage in the TNM system (stage I 100.00%, stage II 87.18%, stage III 75.17%, and stage IV 16.67%. p<0.0001), but there were inverse 5-year OS or overlapped survival in the Lugano (81.48% in stage II, 85.71% in stage IIE) and Ann Arbor systems (69.47% in stage IIE, 66.67% in stage IIIE). In aggressive lymphomas, the 5-year OS of TNM stage I, stage II, stage III , and stage IV was 100.00%, 81.34%, 63.52%, and 16.00%, respectively (p=0.0002), but there were overlapped survival curves in Lugano and Ann Arbor systems. The 5-year OS of patients with T1 or T2 was significantly superior compared to patients with T3 or T4 (96.15 vs 67.92%, p=0.0087), and multivariate Cox analysis showed that T (p=0.0181) and M (p=0.0031) were the covariates prognostically significant for OS.
TNM staging system may be superior to Lugano and Ann Arbor system in predicting OS of patients with PGL.
评估TNM、卢加诺（Lugano）和安阿伯（Ann Arbor）分期系统对原发性胃肠道淋巴瘤（PGL）患者的生存预测价值。
回顾性分析101例PGL患者。所有患者均按照TNM、卢加诺或安阿伯分期系统进行分期。将5年总生存率/OS率作为主要临床结局。评估肿瘤浸润深度（T）、淋巴结状态（N）、转移情况（M）、性别、年龄、乳酸脱氢酶（LDH）、美国东部肿瘤协作组体能状态（PS）、亚型及肿瘤部位等不同变量与临床结局的预后价值。
中位随访时间为46.6个月（范围1.3 - 158.6个月）。估计5年OS率为74.22%。在胃淋巴瘤中，TNM系统的5年OS率与分期密切相关（I期100.00%，II期87.18%，III期75.17%，IV期16.67%，p<0.0001），但在卢加诺（II期81.48%，IIE期85.71%）和安阿伯系统（IIE期69.47%，IIIE期66.67%）中，5年OS率存在反向或重叠情况。在侵袭性淋巴瘤中，TNM分期I期、II期、III期和IV期的5年OS率分别为100.00%、81.34%、63.52%和1�.00%（p = 0.0002），但在卢加诺和安阿伯系统中生存曲线存在重叠。T1或T2期患者的5年OS率显著高于T3或T4期患者（96.15%对67.92%，p = 0.0087），多因素Cox分析显示T（p = 0.0181）和M（p = 0.0031）是OS的预后显著协变量。
在预测PGL患者的OS方面，TNM分期系统可能优于卢加诺和安阿伯系统。
