【摘要】 背景与目的:本研究承起参考文献[1],旨在对鼻咽癌AJCC/UICC(1997)分期进行进一步验证和提出适当的建议。方法:同参考文献[1]。结果:Cox模型分析表明年龄、AJCC/UICC(1997)TNM分期或T和N分期与915例患者生存状况显著相关,统计学差异显著。选择年龄≤60岁患者803例再行Cox模型分析,生存状况仅与AJCC/UICC(1997)大体分期或T和N显著相关,而与年龄的相关不具统计学显著性。803例鼻咽癌的寿命表法分析表明,AJCC/UICC(1997)分期基本可反映预后,但Ⅰ和Ⅱa期,Ⅳa和Ⅳb期两两比较生存率差异不显著。Kaplan-Meier法分析表明在考虑N分期因素影响下,T1和T2a期,T3和T4期差异不显著。考虑T分期因素后,N2和N3a,N3a和N3b两两比较差异不显著。将无咽旁间隙受侵之T2a期下调为T1期;将下颈淋巴结受侵之N1上调为N2期;将N3a期和N3b期合并为N3期;将Ⅰ和Ⅱa期合并为Ⅰ期;Ⅳa和Ⅳb期合并为Ⅳa期;Ⅱb期改为Ⅱ期。重新进行分析,调整后大体分期、T和N各自组间比较差异具统计学显著性,分组更具合理性。结论:在充分考虑年龄对预后的影响及T分期和N分期相互影响的前提下,本组病例对AJCC/UICC(1997)鼻咽癌分期系统的验证提示可对其进行以上调整。更多还原

【Abstract】 BACKGROUND & OBJECTIVE: On the basis of our previous research (as shown in reference [1]), this study was to validate the rationality of AJCC/UICC staging system (1997) of nasopharyngeal carcinoma (NPC), and to provide some suggestions. METHODS: Survival data of 915 NPC patients, received radical radiotherapy alone in Cancer Center of Sun Yat-sen University from Jan. 1997 to Dec. 1998, were analyzed with Life table, Cox regression, Kaplan-Meier, and log-rank methods. RESULTS: Cox regression analysis showed that the 5-year survival rate of the 915 patients was significantly correlated to their age and tumor stage classified according to AJCC/UICC (1997) staging system; while that of the 803 patients no more than 60 years old was only significantly correlated to tumor stage. Life table analysis validated that the tumor stage classified according to AJCC/UICC staging system can roughly predict the prognosis, but the differences between stage Ⅰand Ⅱa, or Ⅳa and Ⅳb were not significant. Kaplan-Meier analysis showed no significant differences of survival rate between stage T1 and T2a, or T3 and T4 when adjusted by N classification, and between stage N2 and N3a, or N3a and N3b when adjusted by T classification. Therefore, we adjusted stage T2a to T1, stage N1 with inferior cervical nodes metastasis to N2, combined stage N3a and N3b to N3, adjusted stage Ⅱa to Ⅰ, stage Ⅱb to Ⅱ, and stage Ⅳb to Ⅳa. After the modifications, the differences among stages Ⅰ-Ⅳa, T1 -T4 (adjusted by N classification) and N0-N3 (adjusted by T classification) were significant. CONCLUSION: Taking the impact of age on the prognosis and the interaction between T stage and N stage into consideration, the above modifications should be included when renewing the AJCC/UICC staging system (1997).更多还原