Schmitz-Moormann P, Himmelmann G W, Baum U, Nilles M
Department of Pathology, Philipps-University, Marburg, Federal Republic of Germany.
J Cancer Res Clin Oncol. 1987;113(6):586-92. doi: 10.1007/BF00390871.
In 150 curative resected adenocarcinomas of the large bowel we analyzed the morphological parameters of the primary tumor and lymph node involvement which most efficiently expressed the relationship to survival time. Using univariate survival analysis (product limit estimator according Kaplan-Meier), several macroscopical and microscopical parameters of the primary tumor and lymph node involvement significantly correlated with survival time. A multivariate survival analysis of covariates according to the Cox regression model revealed that the significant correlations of all these parameters were expressed by a set of five variables: pT stage, number of inflammatory cells, sex, age, and pN stage. As shown by the Kaplan-Meier test, this set of variables allowed a more precise prediction of survival time than mere staging according to the TNM system. Parametric multiple stepwise survival analysis was inefficient. No distinct relationship was found between the morphology of the primary tumor and the involvement of lymph nodes.
在150例接受根治性切除的大肠腺癌患者中,我们分析了原发肿瘤的形态学参数以及淋巴结受累情况,这些参数能最有效地体现与生存时间的关系。采用单变量生存分析(根据Kaplan-Meier法的乘积限估计量),原发肿瘤和淋巴结受累的几个宏观及微观参数与生存时间显著相关。根据Cox回归模型对协变量进行多变量生存分析显示,所有这些参数的显著相关性由一组五个变量体现:pT分期、炎症细胞数量、性别、年龄和pN分期。如Kaplan-Meier检验所示,相较于单纯依据TNM系统进行分期,这组变量能更精确地预测生存时间。参数化多步生存分析效率不高。未发现原发肿瘤形态与淋巴结受累之间存在明显关系。