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肾细胞癌简称肾癌,是泌尿外科领域最常见的恶性肿瘤之一。其发病率占泌尿系肿瘤之第二位。肾癌准确的分期直接关系到对其制定正确合理的治疗方案和判断患者的预后,因此极为重要。1968后,Robson在Flocks和Kadseky分类基础上提出了肾癌四期分期法;2002年AJCC(美国癌症联合委员会)的TNM分期法得到国内外广泛的临床应用。但随着临床研究的进展出现了新的观点,到2009年,AJCC对肾癌TNM分期又提出了4点修改意见。可见,随着科学的发展,临床研究的深入,对肾癌的诊治和分期必然会出现一些新观点、新动向,应及时增添进肾癌的分期之中。鉴于上述,我们试图提出一个更简明扼要、易于临床操作、实用性强的新方案,供同道们探讨,起抛砖引玉之效应。我们的方案主要强调先将肾癌的临床表现划为三大类型,即局限型肾癌、局部进展型(或称局部浸润转移型)肾癌和转移型肾癌。然后在每一大类型中再依据肿瘤体积、浸润、转移的不同分为4个期(A期、B期、C期、D期)。本文新分期法简单明了,一目了然,易操作,实用性强。
Renal cell carcinoma, referred to as kidney cancer, is one of the most common malignancies in the urology field. The incidence of urinary tract tumors account for the second place. Accurate staging of renal cancer is directly related to the development of a correct and reasonable treatment plan and to determine the prognosis of patients, it is extremely important. After 1968, Robson proposed the four staging of renal cell carcinoma on the basis of Flocks and Kadseky classification. In 2002, TNCC staging method of AJCC (American Joint Committee on Cancer) got extensive clinical application at home and abroad. However, with the progress of clinical research, new opinions emerged. By 2009, AJCC proposed four additional revisions to the TNM staging of renal cell carcinoma. Visible, with the development of science, clinical research in-depth, diagnosis and treatment of renal cell carcinoma and staging will inevitably be some new ideas, new trends, should be added to the staging of renal cell carcinoma. In view of the above, we have tried to come up with a new, concise, easy-to-use and practicable new program for fellow democrats to explore and give a clues. Our program mainly focuses on the first classification of renal cell carcinoma clinical manifestations of three types, namely localized renal cell carcinoma, locally advanced (or locally invasive metastasis) and metastatic renal cell carcinoma. Then in each large type and then according to tumor volume, infiltration, metastasis is divided into four different periods (A, B, C, D). This new staging method is simple, clear, easy to operate, practical.