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基于肿瘤浸润深度及大小的TTS 评分系统对可切除胃癌患者预后判断的价值
引用本文:高利雄1,任显坤1,李贵全1,吴本华1,陈 轩2. 基于肿瘤浸润深度及大小的TTS 评分系统对可切除胃癌患者预后判断的价值[J]. 现代肿瘤医学, 2022, 0(15): 2763-2767. DOI: 10.3969/j.issn.1672-4992.2022.15.017
作者姓名:高利雄1  任显坤1  李贵全1  吴本华1  陈 轩2
作者单位:1.邛崃市医疗中心医院胃肠外科,四川 邛崃 611530;2.西南医科大学附属医院胃肠外科,四川 泸州 646000
摘    要:目的:探讨基于肿瘤浸润深度及大小的TTS评分系统对可切除胃癌患者预后判断的价值。方法:选择行根治性切除的234例胃癌患者为研究对象。根据肿瘤浸润深度(T分期)和肿瘤大小构建TTS评分系统,分为TTS 0级、1级、2级,代表肿瘤侵袭性逐渐升高。通过Cox多因素模型分析TTS评分系统作为预后判断工具的可行性。结果:T1-T4期患者肿瘤的平均大小分别为(3.3±2.7)cm、(4.1±3.1)cm、(6.6±3.1)cm、(9.4±4.9)cm。单因素分析显示,肿瘤浸润深度与肿瘤大小、淋巴结转移、TNM分期、淋巴浸润和血管浸润显著相关(P<0.01)。ROC曲线显示,45 mm为肿瘤大小的最佳界值,可有效区分患者是否存在淋巴结转移,曲线下面积(area under curve,AUC)为0.762。综合肿瘤大小的临界值和肿瘤浸润深度,构建TTS评分系统,TTS 0级、TTS 1级和TTS 2级的患者5年生存率分别为95.6%、83.3%和70.2%,两两比较后发现,不同TTS状态患者的生存率之间均存在显著差异(P<0.01)。Cox多因素分析发现,TTS评分是影响患者预后的独立性危险因素(P<0.05)。结论:本研究根据肿瘤浸润深度和大小构建了TTS评分系统,并证明了TTS评分与胃癌患者的预后密切相关。

关 键 词:胃癌  肿瘤大小  TNM分期

The value of TTS scoring system based on tumor depth and size in prognosis of resectable gastric cancer
GAO Lixiong1,REN Xiankun1,LI Guiquan1,WU Benhua1,CHEN Xuan2. The value of TTS scoring system based on tumor depth and size in prognosis of resectable gastric cancer[J]. Journal of Modern Oncology, 2022, 0(15): 2763-2767. DOI: 10.3969/j.issn.1672-4992.2022.15.017
Authors:GAO Lixiong1  REN Xiankun1  LI Guiquan1  WU Benhua1  CHEN Xuan2
Affiliation:1.Department of Gastroenterology,Qionglai Medical Center Hospital,Sichuan Qionglai 611530,China;2.Department of Gastroenterology,Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China.
Abstract:Objective:To explore the value of TTS scoring system based on tumor depth and size in the prognosis of gastric cancer patients.Methods:234 patients with gastric cancer were selected as the study object.According to T stage and tumor size,TTS scoring system was constructed,which was divided into 0,1 and 2 levels.To analyze and evaluate the feasibility of TTS as a prognostic tool.Results:The average tumor size of T1-T4 patients were (3.3±2.7)cm,(4.1±3.1)cm,(6.6±3.1)cm,(9.4±4.9)cm,respectively.The tumor depth was significantly correlated with tumor size,lymph node metastasis,TNM stage and lymph and vein invasion(P<0.01).ROC curve showed that 45 mm was the best boundary of tumor size,which could effectively distinguish whether there was lymph node metastasis.AUC was 0.762.According to the critical values of tumor invasion depth and tumor size,TTS scoring system was constructed.The 5-year survival rates of TTS 0-2 were 95.6%,83.3% and 70.2% respectively.After comparison,there was a significant difference between the survival rates of patients with different TTS states(P<0.01).Cox multivariate analysis found that TTS score was an independent risk factor for prognosis(P<0.05).Conclusion:According to the depth and size of the tumor,the TTS scoring system is constructed,and it is proved that TTS scoring is closely related to the prognosis of gastric cancer patients.
Keywords:gastric cancer   tumor size   TNM stage
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