不同TNM分期标准在胃神经内分泌癌患者预后评估中的价值  

Comparison of value predicting prognosis between ENETS and AJCC TNM staging system in gastric neuroendocrine carcinoma patients

作　　者：魏建明[1] 刘彤[1] 

机构地区：[1]天津医科大学总医院普外科,300052

出　　处：《中华普通外科杂志》2016年第6期449-452,共4页Chinese Journal of General Surgery

摘　　要：目的探讨不同TNM分期标准在胃神经内分泌癌（gastric neuroendocrine carcinoma，G—NEC）患者预后评估中的价值。方法回顾性分析自2005年1月至2015年9月天津医科大学总医院28例G—NEC患者的临床病理资料。应用欧洲神经内分泌肿瘤协会（European Neuroendocrine Tumor Society，ENETS）TNM分期标准和美国癌症联合委员会（American Joint Committeon Cancer，AJCC）TNM分期标准分别对其预后进行评估。用Kaplan-Miere生存分析比较这两种标准对G-NEC患者预后的评估价值。结果按2006年ENETSTNM分期标准，本组28例G—NEC患者中I期0例，Ⅱ期5例（18％），Ⅲ期20例（71％）和Ⅳ期3例（11％），3组的生存时间相比差异有统计学意义（P〈0．05）；按2010年第7版AJCCTNM分期标准，I期0例，Ⅱ期1例（4％），Ⅲ期24例（86％）和Ⅳ期3例（11％），3组的生存时间相比差异有统计学意义（P〈0．05）。结论AJCC（2010年第7版）TNM分期标准对G—NEC患者的预后评估有一定价值；2006年ENETSTNM分期标准更能精确判别G—NEC的生物学行为，对晚期G—NEC患者的准确判断以及术后辅助治疗具有重要指导作用。Objective To compare the value for predicting prognosis between ENETS and AJCC TNM staging system in G-NEC patients. Methods Clinical data of 28 G-NEC cases from January 2005 to September 2015 in Tianjin Medical University General Hospital were analyzed and follow-up data were staged by he ENETS and AJCC TNM staging system. The survival curves were drawn using Kaplan-Meier method. Univariate analysis was performed by Log-rank test. Results Evaluated by ENETS TNM staging system on these 28 G-NEC patients, 5 cases （18%） were classified at stage , Ⅱ20 cases （71%） were at stage Ⅲ, 3 cases （11% ） at stage IV, and significant difference in survival time was found between the three stages （P 〈0. 05）. By the AJCC TNM staging system, 1 case （4%） was classified at stage 11, 24 cases （86%） were at stage m, and 3 cases （11%） at stage IV, and significant difference in survival time was found between three stages. Conclusions AJCC TNM staging system is more valuable for predicting prognosis of G-NEC, while the ENETS TNM staging system is more accurate in evaluating G-NEC biologic behavior.

关 键 词：神经内分泌瘤 肿瘤分期 预后 

分 类 号：R735.2[医药卫生—肿瘤]