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目的:探讨胃癌第7版UICC分期对判断预后的价值。方法:选择行胃癌根治术、临床病理及随访资料完整的360例胃癌患者为研究对象,按UICC第6版和第7版分别进行TNM分期,Kaplan-Meier生存曲线分析各期5年生存率。结果:360例患者的5年生存率为61.8%,中位生存时间为64.4个月(95%CI:60.6～68.2)。第7版Ⅰ、Ⅱ和Ⅲ期患者的5年生存率分别为95.4%、80.1%和37.4%;ⅡA和ⅡB期分别为81.9%和78.9%,ⅢA、ⅢB和ⅢC期分别为59.3%、46.1%和11.7%。与第6版比较,Ⅲ期各亚组间5年生存率差异有统计学意义,P=0.000。结论:第7版TNM分期更注重肿瘤局部浸润深度和淋巴结转移数目对胃癌预后的影响,所以分析预后更精确;同时分期的调整更符合临床实践的预后判断信息,量化复发风险,可指导不同亚期的患者进行个体化综合治疗。
Objective: To investigate the value of stage 7 UICC staging in predicting the prognosis of gastric cancer. Methods: A total of 360 patients with gastric cancer who underwent radical gastrectomy, clinical pathology and follow-up were enrolled in this study. The 5-year survival rates of each stage were analyzed by Kaplan-Meier survival curves according to the 6th and 7th editions of UICC. Results: The 5-year survival rate was 61.8% in 360 patients and the median survival time was 64.4 months (95% CI: 60.6-68.2). The 5-year survival rates were 95.4%, 80.1% and 37.4% in stage 7, stage I, stage II and stage III respectively, stage IIA and stage IIB were 81.9% and 78.9%, stage IIIA, stage IIIB and stage III C were 59.3%, 46.1 % And 11.7%. Compared with the sixth edition, the difference of 5-year survival rates among the three subgroups was statistically significant (P = 0.000). Conclusion: The 7th edition of TNM stage focuses more on the depth of tumor invasion and the number of lymph node metastasis on the prognosis of gastric cancer, so the analysis of prognosis is more accurate; while the adjustment of staging is more consistent with the clinical practice of prognostic information to quantify the risk of recurrence can guide different Asian Period of patients with individualized comprehensive treatment.