Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan.
Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan.
J Thorac Oncol. 2017 Sep;12(9):1403-1412. doi: 10.1016/j.jtho.2017.06.003. Epub 2017 Jun 13.
The aim of this study was to validate the new eighth edition of the TNM classification and to elucidate whether radiological solid size corresponds to pathological invasive size incorporated in this T factor.
We analyzed the data on 1792 patients who underwent complete resection from 2003 to 2011 at the National Cancer Center Hospital East, Japan. We reevaluated preoperative thin-section computed tomography (TSCT) to determine solid size and pathological invasive size using the fourth edition of the WHO classification and reclassified them according to the new TNM classification. The discriminative power of survival curves by the seventh edition was compared with that by the eighth edition by using concordance probability estimates and Akaike's information criteria calculated using a univariable Cox regression model. Pearson's correlation coefficient was calculated to elucidate the correlation between radiological solid size using TSCT and pathological invasive size.
The overall survival curves in the eighth edition were well distinct at each clinical and pathological stage. The 5-year survival rates of patients with clinical and pathological stage 0 newly defined were both 100%. The concordance probability estimate and Akaike's information criterion values of the eighth edition were higher than those of the seventh edition in discriminatory power for overall survival. Solid size on TSCT scan and pathological invasive size showed a positive linear relationship, and Pearson's correlation coefficient was calculated as 0.83, which indicated strong correlation.
This TNM classification will be feasible regarding patient survival, and radiological solid size correlates significantly with pathological invasive size as a new T factor.
本研究的目的是验证第八版 TNM 分类，并阐明影像学实性大小是否与 T 因素中包含的病理侵袭性大小相对应。
我们分析了 2003 年至 2011 年在日本国立癌症中心医院东部分院接受完全切除术的 1792 例患者的数据。我们重新评估了术前薄层计算机断层扫描（TSCT），使用第四版世界卫生组织分类确定实性大小和病理侵袭性大小，并根据新的 TNM 分类对其进行重新分类。使用单变量 Cox 回归模型计算一致性概率估计值和赤池信息量准则，比较第七版和第八版生存曲线的判别能力。计算 Pearson 相关系数以阐明使用 TSCT 的影像学实性大小与病理侵袭性大小之间的相关性。
第八版的总体生存曲线在每个临床和病理阶段都有很好的区分。新定义的临床和病理分期 0 的患者 5 年生存率均为 100%。第八版的一致性概率估计值和赤池信息量准则值在总体生存的判别能力方面均高于第七版。TSCT 扫描的实性大小与病理侵袭性大小呈正线性关系，Pearson 相关系数计算为 0.83，表明相关性很强。
该 TNM 分类在患者生存方面是可行的，影像学实性大小与病理侵袭性大小作为新的 T 因素显著相关。
