TNM分期与Lugano分期在预测原发性胃肠道恶性淋巴瘤患者生存中的作用比较  

Comparison of TNM and Lugano staging systems in predicting 5-year survival rate of primary gastrointestinal lymphoma patients

作　　者：常树建[1] 石鑫[1] 徐振宇[1] 刘劝[1] 

机构地区：[1]江南大学附属医院(无锡市第四人民医院)肿瘤科,江苏省无锡市214062

出　　处：《中国肿瘤临床》2015年第7期392-396,共5页Chinese Journal of Clinical Oncology

基　　金：江苏省政府留学奖学金(编号:JS-2013-274)资助~~

摘　　要：目的：比较TNM与Lugano分期系统在预测原发性胃肠道恶性淋巴瘤患者5年生存率中的价值。方法：收集2001年2月至2013年8月手术治疗的原发性胃肠道恶性淋巴瘤患者73例。所有患者分别使用TNM及Lugano系统进行分期。5年生存率为生存比较的主要指标,Kaplan-Meier法绘制生存曲线,并行Log-rank检验。Cox回归分析方法检验不同临床因素对患者生存的影响。结果：本组患者中位随访时间42.4（1.3-158.6）个月,5年生存率77.82%。使用TNM系统分期时,Ⅰ、Ⅱ、Ⅲ期和Ⅳ期患者的5年生存率分别为100.0%、90.0%、67.4%和22.2%（χ^2=17.795 6,P=0.000 5）。使用Lugano分期时,Ⅰ、Ⅱ、ⅡE期和Ⅳ期患者的5年生存率分别为100.0%、100.0%、70.7%和46.2%（χ^2=15.677 6,P=0.001 3）。Cox分析提示肿瘤浸润深度（P=0.018 1）和远处转移（P=0.003）是原发性胃肠道恶性淋巴瘤患者生存的独立预后因素。结论：TNM分期较Lugano分期可以更好地预测原发性胃肠道恶性淋巴瘤患者的5年生存率。Objective：To assess the survival-predictive value of TNM and Lugano staging systems in patients with primary gastro-intestinal lymphoma （PGL）. Methods：A total of 73 patients with PGL were recruited from February 2001 to August 2013. All patients were diagnosed according to the TNM and Lugano staging systems. Five-year survival rate was used as the major clinical outcome. Survival curves were plotted using the Kaplan–Meier method and analyzed with the log-rank test. The prognostic value of different variables for clinical outcomes was assessed using the Cox multiple regression model. Results：The median follow-up time of surviving patients was 42.4 months （range：1.3-158.6 months）. The estimated 5-year overall survival rate was 77.82%. When diagnosed with the TNM system, the 5-year survival rates in stagesⅠ,Ⅱ,Ⅲ, andⅣwere 100%, 90.0%, 67.4%, and 22.2%, respectively （χ^2=17.7956, P=0.0005）. When staged by the Lugano system, the 5-year survival rates in stagesⅠ,Ⅱ,ⅡE , andⅣwere 100%, 100%, 70.7%, and 46.2%, respectively （χ^2=15.6776, P=0.0013）. Cox analysis showed that the invasion depth （T） （P=0.0181） and metastasis （M） （P=0.0031） were covariates that were prognostically significant for the overall survival. Conclusion：The TNM staging system is more accurate than the Lugano system in predicting the 5-year survival rate of patients with PGL.

关 键 词：胃肠道恶性淋巴瘤 5年生存率 TNM Lugano 

分 类 号：R735[医药卫生—肿瘤]