2010年第7版肾癌新分期的应用效果评估  

Validation of the 2010 edition kidney cancer TNM staging system in China

作　　者：孙丹[1] 刁磊[1] 张艳辉[1] 李春香[1] 杜君[1] 姚欣[1] 

机构地区：[1]天津医科大学附属肿瘤医院泌尿肿瘤科天津市肿瘤防治重点实验室,300060

出　　处：《中华泌尿外科杂志》2012年第6期405-408,共4页Chinese Journal of Urology

基　　金：国家自然科学基金（81072090）

摘　　要：目的探讨2010年第7版肾癌新分期系统的临床应用效果。方法收集1981年1月至2003年12月手术治疗的695例肾癌患者的存档资料，分别按照国际抗癌联盟及美国癌症联合会2002年第6版和2010年第7版肾癌分期系统进行临床病理分期，观察不同分期患者的生存情况，应用Kaplan-Meier法、Log—rank检验、Cox比例回归风险模型进行统计学分析。结果按照新分期系统，第6版分期系统中T2期171例中120例归入T2a期，51例归入T2a期，13例因肿瘤侵犯肾上腺而归入T4期，3例并发肾静脉瘤栓者归入T3a期。按第6版分期系统，T3a期中单纯肾周脂肪阳性患者的预后与单纯肾上腺阳性患者比较差异有统计学意义（P=0．008），单纯肾上腺阳性患者预后与T4期肾癌患者比较差异无统计学意义（P=0．412）。新分期系统中，T2b与T3a期预后差异无统计学意义（P=0．741），将T3a期以7cm为分界点分类后，T3a期（肿瘤最大直径≤7cm）与T2a期的预后相近（P=0．342），T3a期（肿瘤最大直径〉7cm）预后与T2b比较差异有统计学意义（P=0．019）。结论第7版肾癌分期系统显示了更好的分期特异性。Objective To validate the 2010 Edition kidney cancer TNM staging in China. Methods Data were collected from 695 operated kidney cancer patients from Jan. 1981 to Dec. 2003. These patients were staged based on the 6th Edition and 7th Edition kidney cancer TNM staging system, respectively. The Kaplan-Meier method, log-rank test and Cox regression models were used to analyze survival functions. Results Compared to the 6th edition staging system, the number of patients with stage T3a, T4 changed from 98 to 88, from 29 to 42 in new staging system, respectively. According to the 6th edition staging system, there was significant difference comparing perirenal fat invasion only with adrenal gland only （ P = 0.08 ）, there was no significant difference comparing Gerota fascia invasion （ stage T4 ） only with adrenal gland invasion only （P = 0. 412）. According to the new staging system, there was no significant difference comparing stage T2b with stage T3. （ P = 0.714）. Conclusion The new kidney cancer staging system has better staging specificity and clinical application results in high accuracy.

关 键 词：肾肿瘤 癌 肿瘤分期 生存分析 

分 类 号：R737.11[医药卫生—肿瘤]