| Background and aims: At present,the TNM staging system is the most common malignant tumors staging system in the world,it also can help the clinical doctors to draw up a diagnostic and medical treatment planning for the patient and predict the survival time and evaluate the prognosis of patients.In 2009,UICC published the seventh edition of the TNM staging standard for non-small cell lung cancer(NSCLC),which has been widely used by clinical doctors and medical researchers all over the world.It has become the main method to evaluate the prognosis of patients with non-small cell lung cancer.However,the seventh edition of the TNM staging system has not been renewed for six years since 2015,and the revised version of the new edition of the non-small cell lung cancer staging system has been published in the Journal of Thoracic Oncology in 2015.The new non-small cell lung cancer staging system standard will be based on its theoretical results as an important basis,and will be officially released in 2017.In this study,the advantages and disadvantages of the two edition of TNM staging system were analyzed and compared.To evaluate the effectiveness of the new staging system in assessing the efficacy and prognosis of patients with non-small cell lung cancer compared with the seventh edition,and whether there are limitations about the eighth edition in the process of practical application.Methods: In 2012,non-small cell lung cancer patients,received curative surgical resection at the Department of Thoracic Surgery,in Affiliated Hospital of Qingdao University,were enrolled in our study.A retrospective analysis is conducted on these patients.Collect the patient's gender,age and other basic information,surgical type,characteristics of tumor(including tumor size,location and the histopathologic types),different TNM staging of non-small cell lung cancer(respectively staging for the tumor according to the seventh and eighth edition),patient follow-up results,and survival time and so on.SPSS19.0 software is used for statistical analysis,Use the method of Kaplan – Meier,and resort the method of survival analysis according to stage one by one,and draw the survival curves.The survival time's values of c 2 and P are calculated by Log-rank method.The difference of the prognosis between the seventh and eighth editions of TNM staging system is determined by the P value,and determining whether there are statistical significance about the difference.With P < 0.05,the difference is considered statistically significant.Results: A total of 184 patients are ultimately included in the study.The survival curves of non-small cell lung cancer patients' overall survival time are drew,respectively compared with the seventh and eighth editions of T staging system.All their P value are<0.001.All their differences about the survival curves are statistically significant.In the eighth editions of T staging system,the survival time decrease with the increasing of the T stage level,and there is no intersection or similarity between the survival curves of each T stage.In the survival curves of the eighth editions of T staging system,there are intersections between the T3 and T4 staging,and some of them are intertwined.The survival curves of non-small cell lung cancer patients' overall survival time are drew,respectively compared with the seventh and eighth editions of TNM staging system.All their P value are < 0.001.Their differences about the survival curves are statistically significant.Survival curves show that stage IA and IB are always intertwined.The results showed that the survival rate of patients with lower TNM stage was higher than that of the patients with higher TNM stage except stage I.Conclusion: Compared to the seventh edition staging system,the eighth edition shows better specificity between different stages.Only considering the T staging separately,the eighth edition of TNM staging system can be more accurate at division of T3 and T4 patients with non-small cell lung cancer,and it can be more accurate at assessment of the prognosis of these two stage patients.Of course,the eighth edition of TNM staging system is still not perfect,and there are many limitations.The eighth edition of TNM staging system can not accurately assess the prognosis of patients with stage IA and IB.It is necessary to further verify the rationality and accuracy of the eighth edition of TNM staging system by clinical doctors and medical researchers. |
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