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目的探讨原发性肝癌中国分期与TNM分期对判断手术切除肝癌预后的意义。方法回顾性分析我院1986年1月至2000年12月对246例原发性肝癌患者行手术切除病例的临床资料,其中227例患者随访3年以上。生存率计算采用KaplanMeier法,Longrang比较生存曲线。结果全组术后1、3、5、7、10年无瘤生存率分别为55%、30%、25%、20%及18%。新分期Ⅰa、Ⅰb、Ⅱa、Ⅱb及Ⅲ期术后1、3、5、7、10年无瘤生存期各期间差异均有统计学意义,并与TNM分期有一定相关性。TNM分期Ⅰ、Ⅱ、Ⅲ及Ⅳ期术后1、3、5、7、10年无瘤生存期差异有统计学意义,然Ⅲ、Ⅳ期间比较统计学差异无统计学意义。结论肝癌中国分期由于兼顾肿瘤与宿主肝功能两方面因素,分期更加精确,在反映切除肝癌预后方面具有重要价值。
Objective To investigate the significance of staging and TNM staging of primary hepatocellular carcinoma (HCC) in determining the prognosis of resected hepatocellular carcinoma (HCC). Methods A retrospective analysis of our hospital from January 1986 to December 2000 246 patients with primary liver cancer patients underwent surgical resection of the clinical data, of which 227 patients were followed up for more than 3 years. Survival was calculated using KaplanMeier method, Longrang survival curve comparison. Results The 1, 3, 5, 7 and 10 year postoperative tumor free survival rates were 55%, 30%, 25%, 20% and 18% respectively. There were significant differences between the new stages Ⅰa, Ⅰb, Ⅱa, Ⅱb, and Ⅲ in the periods of 1, 3, 5, 7 and 10 years after operation, and there was some correlation with TNM stage. The TNM stage Ⅰ, Ⅱ, Ⅲ and Ⅳ after 1, 3, 5, 7, 10-year disease-free survival difference was statistically significant, but there was no statistical difference between Ⅲ and Ⅳ statistical significance. Conclusion The staging of HCC in China is more accurate because of both the tumor and host liver function. It has important value in reflecting the prognosis of HCC.