原发性肝癌的中国分期与TNM分期对肝癌切除的预后价值的比较研究  

Prognostic evaluation of China Classification System compared with TNM stage in liver cancer patients undergoing resection

作　　者：盛建明[1] 赵文和[1] 马志敏[1] 冯懿正[1] 周杏仁[1] 方宝山[1] 

机构地区：[1]浙江大学医学院附属第一医院肿瘤外科,杭州310003

出　　处：《中华普通外科杂志》2005年第10期644-646,共3页Chinese Journal of General Surgery

摘　　要：目的探讨原发性肝癌中国分期与TNM分期对判断手术切除肝癌预后的意义。方法回顾性分析我院1986年1月至2000年12月对246例原发性肝癌患者行手术切除病例的临床资料,其中227例患者随访3年以上。生存率计算采用KaplanMeier法,Longrang比较生存曲线。结果全组术后1、3、5、7、10年无瘤生存率分别为55%、30%、25%、20%及18%。新分期Ⅰa、Ⅰb、Ⅱa、Ⅱb及Ⅲ期术后1、3、5、7、10年无瘤生存期各期间差异均有统计学意义,并与TNM分期有一定相关性。TNM分期Ⅰ、Ⅱ、Ⅲ及Ⅳ期术后1、3、5、7、10年无瘤生存期差异有统计学意义,然Ⅲ、Ⅳ期间比较统计学差异无统计学意义。结论肝癌中国分期由于兼顾肿瘤与宿主肝功能两方面因素,分期更加精确,在反映切除肝癌预后方面具有重要价值。Objective To evaluate the prognostic value of China Classification System and TNM staging in patients with liver cancer undergoing resection. Methods From Jan 1986 to Dec 2000, 246 patients underwent resection of liver cancer. At least three years of follow-up was made in these 246 cases. Results The 1, 3, 5, 7, and 10-year disease-free survival rates were 55% , 30% , 25% , 20% and 18%, respectively. The 1,3,5,7,and 10-year disease-free survival rates predicted by China Classification System and TNM staging were statistically different and positively correlated with each other. Differences of survival rate between stage Ⅰ a, Ⅰ b, Ⅱ a , Ⅱ b and m by China Classification System were all statistically significant. Conclusions Based both on tumor extension and liver function, China Classification System was more accurate in than TNM stage predicting the prognosis of liver cancer patients undergoing resection.

关 键 词：癌 肝细胞 肿瘤分期 预后 

分 类 号：R735.7[医药卫生—肿瘤]