目前世界各国临床应用的国际抗癌联盟（Union for International Cancer Control,UICC）第7版肺癌TNM分期标准是2009年颁布的,至今已有6年多没有修订。在过去的6年多时间里,肺癌的诊断和治疗研究领域取得了巨大的进展和长足的进步,特别...目前世界各国临床应用的国际抗癌联盟（Union for International Cancer Control,UICC）第7版肺癌TNM分期标准是2009年颁布的,至今已有6年多没有修订。在过去的6年多时间里,肺癌的诊断和治疗研究领域取得了巨大的进展和长足的进步,特别是薄层高分辨CT及正电子发射计算机断层显像（positron emission tomography-computed tomography,PET-CT）的广泛应用筛查出大量早期肺癌患者。展开更多
AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of ...AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.展开更多
众所周知，国际抗癌联盟（Union for International Cancer Control，UICC）TNM分期系统已经成为世界范围内评估胃癌预后及提供临床治疗最重要的参考标准。2002年国际抗癌联盟颁布了第6版胃癌TNM分期系统，并广泛应用于临床，经过近8年...众所周知，国际抗癌联盟（Union for International Cancer Control，UICC）TNM分期系统已经成为世界范围内评估胃癌预后及提供临床治疗最重要的参考标准。2002年国际抗癌联盟颁布了第6版胃癌TNM分期系统，并广泛应用于临床，经过近8年的临床验证，第6版胃癌TNM分期系统的缺陷逐步呈现出来。由此，2010年国际抗癌联盟颁布了第7版TNM分期系统，相对于第6版而言，第7版TNM分期系统在肿瘤浸润深度、淋巴结转移和TNM分期的内容上做了较大变动。自第7版TNM分期系统应用以来，部分学者对第6版与第7版胃癌TNM分期系统的应用价值进行了比较，故本文对此做一解读，试图阐明第7版胃癌TNM分期系统的优劣。展开更多
文摘目前世界各国临床应用的国际抗癌联盟（Union for International Cancer Control,UICC）第7版肺癌TNM分期标准是2009年颁布的,至今已有6年多没有修订。在过去的6年多时间里,肺癌的诊断和治疗研究领域取得了巨大的进展和长足的进步,特别是薄层高分辨CT及正电子发射计算机断层显像（positron emission tomography-computed tomography,PET-CT）的广泛应用筛查出大量早期肺癌患者。
文摘AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.
文摘众所周知，国际抗癌联盟（Union for International Cancer Control，UICC）TNM分期系统已经成为世界范围内评估胃癌预后及提供临床治疗最重要的参考标准。2002年国际抗癌联盟颁布了第6版胃癌TNM分期系统，并广泛应用于临床，经过近8年的临床验证，第6版胃癌TNM分期系统的缺陷逐步呈现出来。由此，2010年国际抗癌联盟颁布了第7版TNM分期系统，相对于第6版而言，第7版TNM分期系统在肿瘤浸润深度、淋巴结转移和TNM分期的内容上做了较大变动。自第7版TNM分期系统应用以来，部分学者对第6版与第7版胃癌TNM分期系统的应用价值进行了比较，故本文对此做一解读，试图阐明第7版胃癌TNM分期系统的优劣。
