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摘要:
目的 验证国际抗癌联盟（UICC）第8版肺癌分期方案在中国肺癌患者中的应用价值。 方法 分别应用UICC第8版分期方案和第7版分期方案对2010年6月至2018年4月在北京大学肿瘤医院暨北京市肿瘤防治研究所3 825例Ⅰ~Ⅳ期非小细胞肺癌术后患者的数据进行分期，使用Kaplan-Meier方法对每个亚组的患者进行生存分析，Cox回归方法评估各亚组之间的差异。 结果 按照UICC第8版进行分期后，共有906例（23.7%）患者的分期发生变化，全部转向更晚分期。生存分析显示，根据第8版分期，除ⅠA1和ⅠA2亚组之间（P=0.057）差异无统计学意义以外，其余每两个相邻分期亚组之间的差异均具有统计学意义（均P < 0.05）。T分期和N分期中，每两个相邻亚组之间的差异均具有统计学意义（均P < 0.05）。M分期中，M0和M1a亚组之间的差异具有统计学意义（P < 0.001），而M1a和M1b亚组之间未观察到显著性差异（P=0.397）。 结论 与UICC第7版分期相比，第8版为中国肺癌患者提供了更准确的预后信息，尤其是对于分期为ⅠA1期、ⅠA2期和ⅠA3期的患者。 Abstract:Objective To evaluate the 8th edition of the TNM classification in an independent cohort of Chinese lung cancer patients. Methods Using the UICC 7th and 8th editions of the TNM classification, we retrospectively analyzed 3, 825 Chinese patients who were diagnosed with stageⅠ to Ⅳ non-small cell lung cancer (NSCLC) and received surgical treatment. A survival analysis of each subgroup was carried out using the Kaplan-Meier method. The Cox regression analysis was used to evaluate the differences between subgroups. Results In total, 906 (23.7%) patients were redefined as having a new pStage and shifted to a higher pStage group in the 8th edition. On the basis of the 8th edition of the TNM classification, the differences between every two adjacent stage groups were found to be significant, except between ⅠA1 and ⅠA2 (P=0.057). Significant differences were observed between every two adjacent groups stratified by the T and N descriptors. Besides, significant differences were observed between M0 and M1a (P < 0.001), whereas no significant difference was observed between M1a and M1b (P=0.397). Conclusions Compared with the 7th edition of the TNM classification, the 8th edition provides more accurate prognostic information, particularly among NSCLC patients at pathologic stages ⅠA1, ⅠA2, and ⅠA3. -
Key words:
- TNM classification /
- non-small cell lung cancer (NSCLC) /
- Chinese patients
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表 1 3 825例NSCLC患者的临床资料
表 2 按照UICC第8版肺癌分期系统分期后患者的分期变化情况
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