Wang Liming, Anraku Masaki, Sato Masaaki, Nitadori Jun-Ichi, Nagayama Kazuhiro, Kitano Kentaro, Nakajima Jun
Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Department of Thoracic Surgery, The 1st Affiliated Hospital of China Medical University, Shenyang, China.
Ann Thorac Cardiovasc Surg. 2018 Oct 19;24(5):223-229. doi: 10.5761/atcs.oa.18-00051. Epub 2018 May 30.
Early lung adenocarcinoma has been more frequently found recently. The 8th edition of the Union for International Cancer Control (UICC)-Tumor Node Metastasis (TNM) classification for lung cancer has been effective since January 2017. This study aims to elucidate advantages of the current classification for patients with clinical stage 0-IA lung adenocarcinoma, in comparison with the older one.
We retrospectively reviewed the data of clinical stage IA (7th edition) lung adenocarcinoma patients who underwent surgery at our institute from 2001 to 2012, and reclassified them by the 8th edition. Survival analysis was used to evaluate the impact of the two classifications.
In all, 281 cases were eligible. Clinical T-factors (8th) were significant prognostic factors for overall survival (P = 0.001), recurrence-free survival (P <0.001), and cancer-specific survival (P = 0.001). However, those in the previous edition were not (P = 0.894, P = 0.144, and P = 0.822, respectively).
The 8th edition of the UICC-TNM classification predicts postoperative prognosis more precisely than the 7th one in clinical stage 0-IA lung adenocarcinoma. It is probably because the stage distribution of the population, which included in the research project the 8th edition based on, has been changed, and the new edition develops more accurate staging criteria for ground-glass nodule (GGN).
早期肺腺癌近来愈发常见。国际癌症控制联盟（UICC）第8版肺癌肿瘤淋巴结转移（TNM）分类自2017年1月起生效。本研究旨在阐明与旧版分类相比，现行分类对于临床0-IA期肺腺癌患者的优势。
我们回顾性分析了2001年至2012年在我院接受手术的IA期（第7版）肺腺癌患者的数据，并按照第8版进行重新分类。采用生存分析评估两种分类的影响。
总计281例符合条件。临床T因素（第8版）是总生存（P = 0.001）、无复发生存（P <0.001）和癌症特异性生存（P = 0.001）的显著预后因素。然而，旧版中的这些因素并非如此（分别为P = 0.894、P = 0.144和P = 0.822）。
UICC-TNM第8版分类在临床0-IA期肺腺癌中比第7版更精确地预测术后预后。这可能是因为第8版所基于的研究项目纳入人群的分期分布发生了变化，且新版为磨玻璃结节（GGN）制定了更准确的分期标准。
