上颌窦鳞状细胞癌JJC、AJC和UICC T分类的比较研究

A comparative study of the JJC, AJC and UICC T classifications of squamous cell carcinoma of the maxillary sinus.

作者信息

Okawa T, Kita M, Tanaka M, Ikeda M, Ishii T, Ogiuchi H, Aramaki H

出版信息

Nihon Gan Chiryo Gakkai Shi. 1989 Jun 20;24(6):1277-87.

Abstract

Seventy-six cases with squamous cell carcinoma of the maxillary sinus were treated with radiotherapy and surgery with or without intra arterial infusion between 1969 to 1985 at the Tokyo Women's Medical College. T classification was made of all cases using the Japan Joint Committee (JJC, 1967), American Joint Committee (AJC, 1977) and Union Internationale Contre le Cancer (UICC, 1987) classifications. 1) By the JJC classification, there were 20 cases in T2, 44 in T3 and 12 in T4. By the AJC classification, there were 9 cases in T2, 58 in T3 and 9 in T4. The classification of 14 cases were changed from JJC T2 to AJC T3, because of extension to the medial nasal meatus. By the UICC classification, there were 27 T2 cases, 32 T3 and 17 T4. 2) Cervical lymph node metastasis was detected in 14 cases (18%) at initial diagnosis and most were found in T3 and T4 cases. 3) The cumulative 5-year survival rates were 67% for T2, 32% for T3 and 25% for T4 by the JJC classification and statistical differences (p less than 0.05) were seen in T2-T3 and T2-T4. In the AJC classification, these were 71% for T2, 37% for T3 and 22% for T4 and no statistical significance was found among them. By the UICC classification, the 5-year survival was 58% for T2, 26% for T3 and 38% for T4 and marked statistical significance (p less than 0.01) was seen in T2-T3 and T2-T4. 4) The cumulative 5-year survival rate in 14 patients with tumor extension to the medial nasal meatus was 55% and it is appropriate to define this stage as T2 in the new UICC classification. These data suggested that UICC classification (1987) is useful and correlated with prognostic analysis.

摘要

1969年至1985年期间，东京女子医科大学对76例上颌窦鳞状细胞癌患者进行了放疗及手术治疗，部分患者还接受了动脉内灌注治疗。所有病例均采用日本联合委员会（JJC，1967年）、美国联合委员会（AJC，1977年）和国际抗癌联盟（UICC，1987年）的分类标准进行T分期。1）按照JJC分类标准，T2期有20例，T3期有44例，T4期有12例。按照AJC分类标准，T2期有9例，T3期有58例，T4期有9例。14例患者的分期从JJC T2期变更为AJC T3期，原因是肿瘤扩展至鼻中道。按照UICC分类标准，T2期有27例，T3期有32例，T4期有17例。2）初诊时发现14例（18%）有颈部淋巴结转移，大多数见于T3期和T4期病例。3）按照JJC分类标准，T2期、T3期和T4期的5年累积生存率分别为67%、32%和25%，T2期与T3期、T2期与T4期之间存在统计学差异（p<0.05）。按照AJC分类标准，T2期、T3期和T4期的5年累积生存率分别为71%、37%和22%，三者之间无统计学意义。按照UICC分类标准，T2期、T3期和T4期的5年生存率分别为58%、26%和38%，T2期与T3期、T2期与T4期之间存在显著统计学意义（p<0.01）。4）14例肿瘤扩展至鼻中道患者的5年累积生存率为55%，在新的UICC分类中，将此阶段定义为T2期是合适的。这些数据表明，UICC（1987年）分类标准是有用的，且与预后分析相关。