CAJ | 학술논문

目的比较鼻咽癌中国1992、2008分期和国际抗癌联盟(UICC)2010分期标准之间的一致性,评价它们在预测鼻咽癌放疗疗效中的价值.方法回顾分析2000-2005年间347例无远处转移的初治鼻咽癌患者临床资料,对每例患者分别用中国1992、2008和UICC2010分期标准进行T、N和临床分期.采用Kappa法分析3种分期标准间各期病例数分布的一致性.采用Kaplan-Meier法分别计算3种分期标准的5年总生存率、局部无复发和无远处转移生存率,并用Logrank检验其差异.结果中国2008分期和UICC 2010分期标准之间的临床分期、T和N分期的病例构成比例的一致性均优于它们各自与1992分期之间的比较,Kappa值分别为0.700、0.881和0.722.3种分期标准下各临床分期的总生存曲线比较只发现Ⅲ与Ⅳ期间的不同,其中2008分期和UICC2010分期标准下Ⅲ与Ⅳ期间的不同(χ2=4.48,P=0.034和χ2=8.88,P=0.003),而1992分期则相似(χ2=0.40,P=0.526).3种分期标准的局部无复发生存率各T1与T2和T2与T3及T3与T4期间的比较均相似(χ2=1.85、0.53、0.50,P=0.174、0.467、0.479和χ2=1.25、2.10、1.99,P=0.264、0.148、0.159及χ2=0.77、0.60、0.87,P=0.381、0.441、0.350).在3种分期标准的各期无远处转移生存率中,1992分期标准的N0与N1、N1与N2、N2与N3间均相似(χ2=3.71、3.11、2.01,P=0.054、0.078、0.156),2008分期标准的N1与N2、N2与N3间不同(χ2=10.49、5.06,P=0.001、0.024);UICC 2010分期标准中仅N1与N2间不同(χ2=7.73,P=0.005).结论中国2008分期和UICC2010分期标准对鼻咽癌放疗疗效的预测价值相近,且均优于1992分期.
목적 비교비인암중국1992、2008분기화국제항암련맹(UICC)2010분기표준지간적일치성,평개타문재예측비인암방료료효중적개치.방법 회고분석2000-2005년간347례무원처전이적초치비인암환자림상자료,대매례환자분별용중국1992、2008화UICC2010분기표준진행T、N화림상분기.채용Kappa법분석3충분기표준간각기병례수분포적일치성.채용Kaplan-Meier법분별계산3충분기표준적5년총생존솔、국부무복발화무원처전이생존솔,병용Logrank검험기차이.결과 중국2008분기화UICC 2010분기표준지간적림상분기、T화N분기적병례구성비례적일치성균우우타문각자여1992분기지간적비교,Kappa치분별위0.700、0.881화0.722.3충분기표준하각림상분기적총생존곡선비교지발현Ⅲ여Ⅳ기간적불동,기중2008분기화UICC2010분기표준하Ⅲ여Ⅳ기간적불동(χ2=4.48,P=0.034화χ2=8.88,P=0.003),이1992분기칙상사(χ2=0.40,P=0.526).3충분기표준적국부무복발생존솔각T1여T2화T2여T3급T3여T4기간적비교균상사(χ2=1.85、0.53、0.50,P=0.174、0.467、0.479화χ2=1.25、2.10、1.99,P=0.264、0.148、0.159급χ2=0.77、0.60、0.87,P=0.381、0.441、0.350).재3충분기표준적각기무원처전이생존솔중,1992분기표준적N0여N1、N1여N2、N2여N3간균상사(χ2=3.71、3.11、2.01,P=0.054、0.078、0.156),2008분기표준적N1여N2、N2여N3간불동(χ2=10.49、5.06,P=0.001、0.024);UICC 2010분기표준중부N1여N2간불동(χ2=7.73,P=0.005).결론 중국2008분기화UICC2010분기표준대비인암방료료효적예측개치상근,차균우우1992분기.
Objective To compare the agreement among Chinese 1992, 2008 and UICC 2010 staging systems of nasopharyngeal carcinoma (NPC) and evaluate their predictive value of radiotherapeutic prognosis.Methods 347 NPC patients without distant metastasis treated in our hospital from 2000 to 2005 were retrospectively analyzed.Every patient was categorized into T, N, and clinical stage by Chinese 1992, 2008 and UICC 2010 staging systems, respectively.Kappa value was used to evaluate the agreement among three systems.Kaplan-Meier method was used to analyze the 5-year overall survival (OS), local-free survival (LFS) and distant metastasis-free survival (DMFS), the difference between subgroup was tested by Logrank.Results The agreement of clinical stage, T and N stage between Chinese 2008 and UICC 2010 staging system was better than that of them compared to 1992 staging system, Kappa value were 0.700、0.881 and 0.722.The agreement of T stage was better than N and clinical stage among these three staging system.The difference of OS between stageⅢ and stage Ⅳ was significant in Chinese 2008 and UICC 2010 staging system (χ2=4.48,P=0.034;χ2=8.88,P=0.003), and with no different in 1992 staging system (χ2=0.40,P=0.526).There was no significant difference of LFS between T1 and T2,T2 and T3,T3 and T4 in all staging systems (χ2=1.85,0.53,0.50,P=0.174,0.467,0.479;χ2=1.25,2.10,1.99,P=0.264,0.148,0.159;χ2=0.77,0.60,0.87, P=0.381,0.441,0.350).There were no significant differencesin 1992 staging system, while there was significant differences of DMFS between N1 and N2, N2 and N3 in 2008 stage system, N1 and N2 in UICC 2010 stage system.Conclusions The predictive value of Chinese 2008 and UICC 2010 staging system for prognosis were similar, and were better than that of 1992 staging system in NPC.