中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2009年
7期
521-524
,共4页
胆囊肿瘤%肿瘤分期%预后
膽囊腫瘤%腫瘤分期%預後
담낭종류%종류분기%예후
Gallbladder neoplasm%Neoplasm staging%Prognosis
目的 比较Nevin、AJCC两种胆囊癌分期方法的临床应用价值. 方法回顾性分析2000年2月至2006年10月手术治疗的胆囊癌患者90例的临床资料,按两种分期方法评估不同分期的术后生存率、肿瘤切除率、切缘阴性率和术式选择情况.计数资料采用X2检验. 结果随Nevin、AJCC分期增加,患者术后生存率、肿瘤切除率、切缘阴性率显著下降(P<0.05).Nevin Ⅲ期、Ⅳ期患者中切除术与根治术的生存率差异无统计学意义(P>0.05),Ⅴ期患者根治术、扩大根治术的生存率显著高于切除术、引流术、活检术者(P<0.05).AJCC Ⅲ期患者中根治术生存率显著高于切除术、引流术、活检术者(P<0.05),Ⅳ期生存率各术式之间差异尤统计学意义(P>0.05).52例AJCCⅢ期、Ⅳ期按Nevin分期均为Ⅴ期,AJCC Ⅲ期生存率显著高于Ⅳ期(P=0.0001),Ⅲ期切除率显著高于Ⅳ期(P=0.001),Ⅲ期行根治性手术者显著高于Ⅳ期(P=0.001),Ⅳ期行引流术、活检术者显著高于Ⅲ期(P=0.001).结论 Nevin分期与AJCC分期均能较好的评估患者预后及手术的可切除性、切缘阴性率、术式选择.AJCC分期对晚期胆囊癌的划分较Nevin分期更科学.
目的 比較Nevin、AJCC兩種膽囊癌分期方法的臨床應用價值. 方法迴顧性分析2000年2月至2006年10月手術治療的膽囊癌患者90例的臨床資料,按兩種分期方法評估不同分期的術後生存率、腫瘤切除率、切緣陰性率和術式選擇情況.計數資料採用X2檢驗. 結果隨Nevin、AJCC分期增加,患者術後生存率、腫瘤切除率、切緣陰性率顯著下降(P<0.05).Nevin Ⅲ期、Ⅳ期患者中切除術與根治術的生存率差異無統計學意義(P>0.05),Ⅴ期患者根治術、擴大根治術的生存率顯著高于切除術、引流術、活檢術者(P<0.05).AJCC Ⅲ期患者中根治術生存率顯著高于切除術、引流術、活檢術者(P<0.05),Ⅳ期生存率各術式之間差異尤統計學意義(P>0.05).52例AJCCⅢ期、Ⅳ期按Nevin分期均為Ⅴ期,AJCC Ⅲ期生存率顯著高于Ⅳ期(P=0.0001),Ⅲ期切除率顯著高于Ⅳ期(P=0.001),Ⅲ期行根治性手術者顯著高于Ⅳ期(P=0.001),Ⅳ期行引流術、活檢術者顯著高于Ⅲ期(P=0.001).結論 Nevin分期與AJCC分期均能較好的評估患者預後及手術的可切除性、切緣陰性率、術式選擇.AJCC分期對晚期膽囊癌的劃分較Nevin分期更科學.
목적 비교Nevin、AJCC량충담낭암분기방법적림상응용개치. 방법회고성분석2000년2월지2006년10월수술치료적담낭암환자90례적림상자료,안량충분기방법평고불동분기적술후생존솔、종류절제솔、절연음성솔화술식선택정황.계수자료채용X2검험. 결과수Nevin、AJCC분기증가,환자술후생존솔、종류절제솔、절연음성솔현저하강(P<0.05).Nevin Ⅲ기、Ⅳ기환자중절제술여근치술적생존솔차이무통계학의의(P>0.05),Ⅴ기환자근치술、확대근치술적생존솔현저고우절제술、인류술、활검술자(P<0.05).AJCC Ⅲ기환자중근치술생존솔현저고우절제술、인류술、활검술자(P<0.05),Ⅳ기생존솔각술식지간차이우통계학의의(P>0.05).52례AJCCⅢ기、Ⅳ기안Nevin분기균위Ⅴ기,AJCC Ⅲ기생존솔현저고우Ⅳ기(P=0.0001),Ⅲ기절제솔현저고우Ⅳ기(P=0.001),Ⅲ기행근치성수술자현저고우Ⅳ기(P=0.001),Ⅳ기행인류술、활검술자현저고우Ⅲ기(P=0.001).결론 Nevin분기여AJCC분기균능교호적평고환자예후급수술적가절제성、절연음성솔、술식선택.AJCC분기대만기담낭암적화분교Nevin분기경과학.
Objective To evaluate the clinical value of Nevin and AJCC staging system for gallbladder carcinoma. Methods In this study 90 patients diagnosed as gallbladder carcinoma underwent operation in Renji Hospital from February 2000 to October 2006. Patients were staged according to Nevin and AJCC staging system. The difference of survival rate, tumor resection rate, ratio of tumor-free resection margin and surgical procedures were analyzed. Results The survival rate, tumor resection rate and ratio of tumor-free resection margin decreased progressively with increasing Nevin and AJCC stage (P < 0. 05). There was no significant difference between the survival rate for Nevin Ⅲ or Ⅳ patients undergoing radical resection and simple cholecystectomy (P > 0. 05). In Nevin Ⅴ patients, the survival rate for radical and extensive radical resection patients was higher than for palliative patients (P < 0. 05). In AJCC Ⅲ patients, the survival rate for radical patients was significant higher than for palliative patients (P < 0. 05). Nosignificant difference was found between radical and palliative patients in survival time in AJCC Ⅳ (P > 0. 05). 52 patients in AJCC Ⅲ and Ⅳ were staged to Nevin Ⅴ according to Nevin staging system. The survival rate and resectable rate for the patients in AJCC Ⅲ were higher than in AJCC Ⅳ (P = 0. 0001, 0. 001 respectively). The rate of radical operation in AJCC Ⅲ was higher (P = 0. 001), and the rate of palliative operation in AJCC Ⅳ was higher (P = 0. 001). Conclusion Both Nevin and AJCC staging system are useful in the judgement of survival, reeectability, ratio of tumor-free resection margin and the optimal operation. AJCC staging system is more applicable for gallbladder carcinoma patients at advanced stage in terms of predicting prognosis.
