胃癌TNM分期标准第6版和第7版对胃癌术后预后判断的价值比较

目的评价第7版胃癌TNM分期标准对胃癌术后患者预后判断的临床应用价值。方法回顾2002年至2005年在长海医院接受胃癌手术切除的381例胃癌患者的临床资料,分别采用胃癌TNM分期标准第6版和第7版进行分期,比较不同分期患者生存曲线的差异。结果采用第7版胃癌TNM分期标准,各T、N分期的不同组别生存曲线的变化趋势具有统计学意义(P<0.05)。与第6版相比,第7版分期标准更为细化,具体表现为第7版中T2和T3、N1和N2不同组别生存曲线的变化趋势均具有统计学意义(P<0.05)；第6版中为Ⅳ期，经第7版分期降期后的患者的生存率较未降期的患者增高,其差异具有统计学意义(P<0.05)。结论与第6版胃癌TNM分期相比,第7版在T分期和N分期标准的划分更细致、更为合理,对胃癌手术后患者的预后判断更为准确。

The 6th and 7th edition TNM staging system in predicting prognosis of gastric cancer patients after operation: a comparative study

Objective To assess the clinical prognostic value of the 7th edition TNM staging system for gastric cancer patients after operation.Methods The clinical data of 381 gastric cancer patients who received operation in Changhai Hospital during 2002 to 2005 were retrospectively analyzed.And the patients were staged using the 6th and 7th edition of TNM staging system separately.The survival curves of different patients were compared.Results The changes of survival curves were significantly different between different T and N classifications of the 7th edition of TNM staging system(P<0.05).The changes of survival curves were significantly different in patients with different T2 and T3 classifications and different N1 and N2 classifications in the 7th edition(P<0.05).The survival rate of Ⅳ stage patients in the 6th edition,whose stage was down-regulated in the 7th edition,was significantly higher than those of patients whose stages were not down-regulated in the 7th edition(P<0.05).Conclusion The 7th edition provides a more detailed and more rational staging for gastric cancer patients than the 6th edition,especially for the T and N staging classification.The 7th edition also has a more accurate prognostic value for gastric cancer patients.