摘要
目的 探讨修订后的肺癌国际分期的合理性与预后的关系。 方法 回顾性分析中国医学科学院肿瘤医院 196 1年 1月～ 1988年 12月外科手术切除的 946例肺癌患者临床资料 ,选取 2 9个可能对预后有影响的变量输入计算机 ,用生命表法 (Life table)分别计算修订前后两种P TNM分期的生存率 ,Log Rank统计分析进行显著性检验 ,Cox模型预后分析来综合评价众多预后因素对生存的影响 ,从而评价修订后肺癌TNM分期的合理性、在判断预后中的作用及有待改进的方面。 结果 影响肺癌外科治疗的预后因素依次是 :P TNM分期、转移淋巴结数目、手术切除性质、肿瘤大小及病理类型。修订后的P TNM分期ⅠA、ⅠB、ⅡA、ⅡB、ⅢA、ⅢB的 5年生存率分别是 6 8 4%、5 9 5 %、44 8%、36 5 %、2 6 3%、及 2 4 8%。除ⅢA与ⅢB期P >0 0 5 ,其余各期间P <0 0 5。 结论 修订后的肺癌TNM分期对判断预后、指导治疗更为客观合理 ;但仍不是尽善尽美的 。
Objective To evaluate the rationality the revised international system for staging lung cancer and its relationship with prognosis. Methods Between January 1961 and December 1988, 946 patients were subjected to removal of lung cancer and the data were analyzed using life table, Log rank test, and Cox regression model. Twenty nine prognostic factors influencing the survival rate were evaluated with SAS6.12 software. The survival rate was calculated according to the two different staging systems. The revised system for staging lung cancer was evaluated. Results The factors influencing prognosis after surgical treatment of lung cancer were as follows: P TNM staging, metastatic lymph nodes, radical or palliative resection, tumor size, and different cell types. The 5 year survival rate of patients with stage ⅠA,ⅠB,ⅡA,ⅡB,ⅢA,ⅢB was 68 4%,59 5%,44 8%,36 5%,26 3%,and staging 24 8%, respectively (ⅢA and ⅢB P>0 05;other stages P<0 05). Conclusions The revised system for lung cancer is more rational and objective to estimate prognosis and direct treatment. But it should be revised further.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2000年第3期189-191,共3页
Chinese Journal of Surgery
