摘要
目的 以 5 a生存率为指标探讨肺癌 TNM分期的适用性。方法 收集 365例肺癌病例的临床及 5 a随访资料 ,用 Fox- pro6.0建立数据库并采用 K- M生存曲线描述各因素间的生存过程 ,用单因素和多因素 COX比例风险回归模型对各危险因素进行分析 ,对重要因素进行两两比较与卡方检验。结果 UICC97分期 T1 、N与 M分期较为合理 ,但 T2 生存率偏低 ,而 T3 与 T4生存曲线出现重迭交叉 (P>0 .0 5)。T2 期肿瘤大于 8cm,T3 期心包侵犯并积液组 5a生存率低于均同期其他组。结论 UICC T分期尚存不足。T2 类肿瘤直径大于 8cm,宜作 T3 ,T3 类心包侵犯并积液 ,建议归为T4期。
Objective To validate the TNM definitions for lung cancer using 5 years survival rate.Methods Clinical and 5 year's follow-up data of 365 patients with lung cancer were reviewed, and input into Foxpro 6.0 database.Survival rates among all factors were descripted using Kaplan merier survival curves.Each risk factor was analyzed using one and multiway cox proportional hazards model,and chi square test and comparison between two important risk factors were performed.Results With regard to the primary tumor,T 1?N?M classification were identical to our results,but patients with T 2 staging had lower 5 years postoperative survival rate.The survival curves were crossed for T 3 and T 4 staging(P>0.05).When tumor at T 2 staging was more than 8.0cm in diameter,or at T 3 staging invaded parietal pericardium complicated with pericardium effusion,the 5 year's survival rates were lower than that without such manifestations.Conclusion TNM classification of UICC was not flawless.Tumors more than 8.0cm at T 2 staging in greatest dimension were suggested to be classified into T 3 staging,and for T 3 tumors which directly invaded parietal pericardium and were complicated with pericardium effusion were recommended to be divided into T 4.
出处
《中国误诊学杂志》
CAS
2002年第11期1610-1613,共4页
Chinese Journal of Misdiagnostics
