摘要
目的:评价三种常用的胃癌淋巴结分级方法的临床应用价值。方法:将409例施行胃癌根治术病例按第4版、第5版UICC分期及第13版JGC分期pN分级方法分组,比较不同组别患者术后5年生存率,并与浸润深度等主要临床病理学因素对照。结果:UICC的两种pN分级5年生存率间差异具有统计学意义(P<0.05),第5版UICC分级差异更为显著(P<0.01),而第13版JGCpN分级组间差异无统计学意义(P>0.05)。三种pN分级、分层比较显示第5版TNM分期pN分级的各层间的生存率差异无显著性意义(P>0.05),提示区域淋巴结转移的数目较转移距离和转移位置范围对反映预后更为重要。Spearman相关性分析显示第5版TNM分期的pN分级与胃癌生物学行为的关系较其他两种pN分级更为密切。COX模型多因素分析表明,第5版TNM分期pN分级是反映胃癌预后最主要的独立指标。结论:第5版TNMpN分级既显示了与预后的一致性,又较好地反映了胃癌的生物学行为,是指导胃癌治疗、判断预后较为合理的指标。
Objective： To evaluate three kinds of lymph node staging for gastric cancer. Methods： A total of 409 gastric cancer patients were divided into three groups according to the 4th and 5th edition of UICC TNM classification and the 13th edition of JGC TNM classification and their clinical data were reviewed. The 5-year survival rate in the three groups was compared and other clinical and pathological factors such as depth of infiltration were analyzed. Results： There was a significant difference in the 5-year survival rate between pN stages of the 4th and 5th edition of UICC TNM classification （P〈 0.01）. No significant difference was found in the 5-year survival rate among different pN stages of the 13th edition of JGC TNM classification （P〉0.05）. Stratified analysis of each of the three kinds of pN staging showed that there was no significant difference in the 5-year survival rate among different pN stages of the 5th edition TNM classification. The pN staging of the 5th edition TNM classification was distinctly superior to the other two pN staging systems. The pN staging of the 5th edition TNM classification was highly correlated with the biological behavior of gastric cancer. Multivariable Cox model analysis showed that the pN staging of the 5th edition TNM classification was the primary independent index reflecting prognosis of gastric cancer. Conclusion： Compared with other pN staging systems, the pN staging of the 5th edition of UICC TNM classification not only correlates with prognosis, but it also reflects the biological behavior of gastric cancer. It is a superior index for optimizing treatment and judging prognosis of gastric cancer.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2007年第24期1410-1413,共4页
Chinese Journal of Clinical Oncology
关键词
胃癌
淋巴结分级
生物学行为
预后
Gastric cancer Lymph node staging Biological behavior Prognosis
