中国普通外科杂志2016，Vol.25Issue(7)：952-956,5.DOI:10.3978/j.issn.1005-6947.2016.07.004
原发性肝癌患者TNM分期与术后生存关系：SEER数据库分析
Association of TNM stage with postoperative survival in patients with primary liver cancer：an analysis of SEER database
摘要
Abstract
Objective: To investigate the guiding signiifcance of the criteria of TNM classiifcation (6th edition) developed by American Joint Committee on Cancer (AJCC) in estimating prognosis of primary liver cancer (PLC). <br> Methods: A total of 2 456 PLC patients undergoing liver resection recorded in the seer database between 2004 and 2010 were included in this study. Of the patients, 2 270 cases (92.4%) had hepatocellular carcinoma (HCC), 145 cases (5.9%) had intrahepatic cholangiocarcinoma (ICC), and 41 cases (1.7%) had combined HCC and ICC (cHCC-ICC). hTe overall survivals (OS) of the patients with different types of PLC were analyzed and compared, and the relations of TNM classiifcation with the prognosis of the patients were also analyzed. <br> Results: hTe 1-, 3-, and 5-year OS was 83.0%, 58.1% and 46.6% in HCC patients, 80.0%, 45.5% and 26.2% in ICC patients and 63.4%, 29.3% and 29.3% in cHCC-ICC patients respectively, and the OS in the former was significantly better than those in the latter two groups (P=0.049, 0.004), but showed no statistical difference between the latter two groups (P>0.05). For HCC or ICC, the OS in patients with TNM stage I was signiifcantly better than those in patients with other TNM stages (allP<0.05), but no statistical difference was noted among patients in different stage III stratiifcations (IIIA, IIIB, IIIC) (bothP>0.05); for cHCC-CC patients, the OS had no statistical difference among patients of all TNM stages (P>0.05). hTe presence of lymph node metastasis (N1) in PLC was rare (3.9%), and OS showed no statistical difference among HCC, ICC and cHCC-CC patients with N0 disease (P>0.05). <br> Conclusion: hTere are some limitations in TNM staging system for estimation of prognosis of PLC, so some new pathological indicators should be incorporated into the system so as to satisfy clinical needs.关键词
肝肿瘤/肿瘤分期/预后/SEER规划Key words
Liver Neoplasms/Neoplasm staging/Prognosis/SEER Program分类
医药卫生引用本文复制引用
陶一明,冯铁诚,王志明..原发性肝癌患者TNM分期与术后生存关系：SEER数据库分析[J].中国普通外科杂志,2016,25(7):952-956,5.基金项目
国家自然科学基金面上资助项目（81372630；81372631）；湖南省发改委科研项目（湘发改高技[2013]1199）；中南大学湘雅医院2014年度临床科研基金资助项目（2014L07）；湘雅医院--北大未名临床与康复研究基金资助项目 （）
“湘雅临床大数据系统”资助建设资助项目（22）。 （）
