非手术治疗食管癌的临床分期与手术病理分期一致性的初步探讨

Preliminary study of the conformity of non-surgical TNM with pathological TNM in esophageal carcinoma

目的探讨非手术治疗食管癌的临床分期标准(草案)与手术病理分期的一致性。方法对2009年1月至2010年6月112例具有完整术前相关临床资料的食管癌患者,根据非手术治疗食管癌的临床分期标准,进行术前临床TNM分期,并与术后病理TNM分期比较,采用Kappa检验行一致性分析。结果临床T分期、N分期、TNM分期与术后病理相应分期的Kappa值分别为0.545、0.615和-0.090(P<0.05)。结论非手术临床分期的T分期、N分期与术后病理T分期、N分期具有中等程度的一致性,而两者的TNM分期无一致性,非手术临床分期是否能够取代术后病理分期还需进一步探讨。

Objective To study the conformity of non-surgical TNM with pathological TNM of esophageal carcinoma.Methods From Jannuary 2009 to June 2010,clinical T staging,N staging and TNM staging based on physical examination,esophagram,esophogogastroscopy and thoracic CT was made according to non-surgical standard.Pathoiogical T staging,N staging and TNM staging was made according to the result of esophageal.The conformity of staging was examined by kappa value.Results The kappa value in the T staging and N staging was higher than the effective standard value of 0.4（Kappa=0.545,0.615;P0.05）,but the kappa value in the TNM staging was lower than 0.4（Kappa=-0.090,P0.05）.Conclusion Though there are some agreements and correlations between the two staging systems,it still needs further exploration to prove whether the non-surgical TNM can replace the pathological TNM or not.