胃癌第7版TNM分期的临床应用

Clinical Evaluation of 7th Edition TNM Staging in Gastric Cancer

目的:分析胃癌第7版与第6版TNM分期之间的差别。方法:回顾性分析316例胃癌患者的临床病理资料,按第6版及第7版TNM分期标准分别进行分期,并分析各期5年生存率。结果:两版TNM分期在同一期之间生存差异无统计学意义(P>0.05);第7版Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期5年生存率分别为64.2%、49.9%、17.8%、0.0%,4个分期5年生存率差异有统计学意义(P<0.05);ⅢA期、ⅢB期、ⅢC期5年生存率分别为32.2%、28.2%、5.0%,3个亚期5年生存率差异具有统计学意义(P<0.05)。结论:第7版TNM分期更加细化,并对患者预后做出科学的评估。对不同分期的患者进行个体化综合治疗,具有临床应用价值。

Objective To compare staging between the 6th and the 7th TNM classifications and to evaluate the prognostic impact in gastric cancer. Methods A total of 316 patients with gastric cancer who had undergone surgical treatment were enrolled in the study. The 5-year survival rates were analyzed according to the staging based on the 6th and 7th systems. Results The 5-year survival rates showed no significant differences in the same stage between 6th and 7th TNM staging （P 〉 0.05）. The 5-year survival rates of stage I, II, III and IV were 64.2%, 49.9%, 17.8% and 0.0% respectively by the 7th TNM staging. There were statistical significances in the 5-year survival rates in different stages（P 〈 0.05）. The 5-year survival rates of the 7th TNM staging of m A, III B and III C were 32.2%, 28.2% and 5.0% respectively, there also were statistical significanees in the different sub-stages （P 〈 0.05）. Conclusion The definition of stage III in the 7th edition of UICC staging is much more reasonable as compared with that in the 6th edition. Clear 7th edition TNM staging is likely to provide the appropriate prognosis assessment and useful information for clinical therapeutic strategy.