第七版与第八版美国癌症联合会TNM分期对口咽癌预后生存的分析比较

张永侠; 刘明波; 黄辉; 陈汶; 张彬

doi:10.13201/j.issn.1001-1781.2019.07.003

第七版与第八版美国癌症联合会TNM分期对口咽癌预后生存的分析比较

- 1 中国人民解放军总医院第一医学中心耳鼻咽喉头颈外科(北京, 100853);
- 2 北京协和医学院中国医学科学院肿瘤医院头颈外科;
- 3 北京协和医学院中国医学科学院肿瘤医院流行病学教研室
基金项目:
解放军总医院科技创新苗圃基金 (No:16KMM23)

详细信息

通讯作者: 张彬,E-mail:docbinzhang@hotmail.com

中图分类号: R739.6

收稿日期: 2019-03-27

A comparison of the 7th and 8th edition of the AJCC TNM staging systems for predicting survival in oropharyngeal cancer

- 1 Department of Otorhinolaryngology Head and Neck Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China;
- 2 Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College;
- 3 Department of Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, Peking Union Medical College

More Information

Corresponding author: ZHANG Bin, E-mail: docbinzhang@hotmail.com

Received Date: 27 March 2019

摘要

摘要: 目的:比较第七版与第八版美国癌症联合会(AJCC)TNM分期对口咽癌生存的预测情况。方法:回顾性分析142例口咽鳞状细胞癌患者的临床病理资料。p16蛋白检测采用免疫组织化学染色法。生存率及生存分析采用Kaplan-Meier法和Log-rank检验。结果:142例口咽鳞状细胞癌患者5年疾病特异生存率(DSS)为55.4%,总生存率为50.4%,中位生存时间60.3个月。口咽鳞状细胞癌患者p16蛋白阳性表达率为27.5%(39/142)。依据第七版AJCC分期,Ⅰ期患者4例,Ⅱ期17例,Ⅲ期27例,Ⅳ期94例;Ⅰ~Ⅱ期患者5年DSS为75.9%,Ⅲ~Ⅳ期患者为52.2%,但二者差异无统计学意义(P=0.109)。而在第八版AJCC分期中,Ⅰ期患者22例,Ⅱ期24例,Ⅲ期27例,Ⅳ期69例;各临床分期5年DSS分别为:Ⅰ期88.4%,Ⅱ期80.5%,Ⅲ期73.2%,Ⅳ期29.1%,总体上比较差异有统计学意义(P=0.000)。结论:与第七版分期相比,第八版AJCC口咽癌分期系统考虑了不同病因口咽癌患者的预后情况,能够更加准确地预测患者的预后。
- 口咽 /
- 癌 /
- 鳞状细胞 /
- TNM肿瘤分期 /
- 预后
Abstract: Objective: The aim of this study is to evaluate the prognostic value of the 8th edition of AJCC TNM classification in comparison with the 7th edition for oropharyngeal cancer. Method: The clinical and pathological data of 142 patients with oropharyngeal squamous cell carcinoma were retrospectively analyzed. The p16 protein was detected by immunohistochemical staining. Survival and survival analysis were performed using the Kaplan-Meier method and the Log-rank test.Result: The 5-year disease-specific survival(DSS), the 5-year overall survival (OS) and the median survival time for patients with oropharyngeal cancer were 55.4%, 50.4% and 60.3 months, respectively. P16-immunostaining was scored positive in 39 samples (27.5%, 39/142). Based on the seventh edition of AJCC staging, there were 4 patients in stage Ⅰ, 17 patients in stage Ⅱ, 27 patients in stage Ⅲ and 94 patients in stage Ⅳ, respectively. However, there was no significant difference in survival between the patients with stage Ⅰ-Ⅱ and those with Ⅲ-Ⅳ (5-year DSS: 75.9% of stage Ⅰ-Ⅱ patients vs. 52.2% of stage Ⅲ-Ⅳ patients; P=0.109). In comparison, 22 patients were diagnosed as stage Ⅰ, 24 were stage Ⅱ, 27 were stage Ⅲ and 69 were stage Ⅳ using the eighth edition. The 5-year DSS for patients with stage Ⅰ, Ⅱ, Ⅲ and Ⅳ was 88.4%, 80.5%, 73.2% and 29.1%, respectively. The overall difference was statistically significant (P=0.000).Conclusion: Compared with the seventh edition staging, the eighth edition of the AJCC oropharyngeal cancer staging system considers the prognosis of patients with different causes of oropharyngeal cancer, and can more accurately predict the prognosis of patients.
- oropharynx /
- carcinoma /
- squamous cell /
- TNM staging /
- prognosis

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