对比两种分期系统在原发性胃肠道恶性淋巴瘤生存预测中的作用

摘要

目的：对比分析 TNM 分期与 Lugano 分期在原发性胃肠道恶性淋巴瘤生存预测中的作用。方法回顾性分析2006~2010年2月原发性胃肠道恶性淋巴瘤50例临床资料，采用 Cox 回归分析方法对患者资料进行分析。随访至2015年，统计患者5年生存状况，采用 Kaplan Meier 方法绘制5年生存曲线。结果随访截止日期为2015年2月，50例患者均随访5年，共11例患者死亡，5年生存率为78.00%。各 TNM 分期5年生存率：Ⅰ期100%，Ⅱ期83.3%，Ⅲ期62.5%，Ⅳ期25.0%；Lugano 分期：Ⅰ期100%，Ⅱ期78.6%，ⅡE 期69.2%，Ⅳ期33.3%，两种方法中各分期中患者生存率经比较，差异具有显著性（ P ﹤0.05）。绘制两种分期方法的5年生存曲线，结果显示：TNM 分期在各期中的生存曲线更为清晰，Lugano 分期生存曲线存在重叠现象。对病理类型发生率较高的弥漫性大 B 细胞淋巴瘤患者进行两种分期测定5年生存率，TNM 分期中4期的5年生存率比较，差异有统计学意义（ P ﹤0.05），Lugano 分期中4期的5年生存率比较，差异无统计学意义（ P ﹥0.05）。结论 TNM 分期相对于 Lugano 分期可更有效地预测原发性胃肠道恶性淋巴瘤患者的5年生存率。%Objective To comparatively analyze the survival prediction role between TNM staging and Lugano staging in patients with pri-mary gastrointestinal lymphoma. Methods The clinical data of 50 patients with primary gastrointestinal lymphoma during 2006 to February 2010 were retrospectively analyzed by using Cox regression analysis. The situation of 5 - year survival rate had been statistically analyzed by using Kap-lan Meier method for drawing the 5 - year survival curves. Results The deadline for follow - up was February 2015,all these 50 patients were followed up for 5 years,a total of 11 patients died,hence the 5 - year survival rate was 78. 00% . Among TNM staging for five - year survival rate:100% in stage I,83. 3% in stage II,62. 5% in stage III,and 25. 0% in stage IV. According to Lugano staging:100% in stage I,78. 6% in stage II,69. 2% in stage III,and 33. 3% in stage IV. In comparison with these 2 staging methods,the difference in survival rate was significant ( P ﹤ 0. 05). The curve drawing of two kinds of staging for 5 - year survival curve showed that TNM staging in the period of survival curve was clearer,the survival curve with Lugano staging was duplicated. A higher incidence of pathological types in patients with diffuse large B - cell lym-phoma,the 5 - year survival rate was measured in two installments,in comparison with 4 stages of five year survival rate byTNM staging,the difference was statistically significant( P ﹤ 0. 05). Lugano 5 - year survival rate in four stages,the difference was not statistically significant( P﹥ 0. 05). Conclusion The results of measurement are more effective with respect to that of Lugano staging than TNM staging in 5 year survival rate of patients with primary gastrointestinal lymphoma.