论文部分内容阅读
癌肿的分期对选择治疗的方案以及其预后的判断有指导价值,病例的疗效随访和不同组别的结果对比必需有一个统一分期系统.美国癌肿联合会(AJCC)联同国际抗癌联盟(UICC)所推行的AJCCTNM分期系统已获得广泛公认和应用.这是一种以原发灶(T)、局部淋巴结(N)以及远处转移灶(M)等特征的解剖学分期方法,有的还考虑一些重要的预后因素.外科医师应与病理科医师一起共同商讨来制订分期,以乳腺癌和结肠癌为例:(一)乳腺癌;T——测定乳腺肿块的最大直径,<2cm为T_1期,再分成T_(la)(<0.5cm)、T_(lb)(0.5～1cm)和 T_(lc)(1～2cm)三期;>2～5cm为 T_2期;>5cm为T_3期;肿瘤侵犯胸腺外为T_4期,再分成T_(4a)(侵犯胸壁)、T_(4b)(侵犯皮肤,如出现水肿、溃疡、卫星结节或桔皮征,皮肤固定或乳头回缩例外)、T_(4c)期(侵犯胸壁和皮肤)和T_(4d)期(乳腺炎性癌).N——分为N_0(无腋淋巴结转移)、N_1(腋淋巴结转移,活动)、N_2(腋淋巴结转移,固定)和 N_3(同侧乳内淋巴结转移),锁骨上淋巴结转移则列为M_1.
The staging of cancer has guiding value for the choice of treatment program and its prognosis. The follow-up of the efficacy of the case and the comparison of the results of different groups must have a unified staging system. The American Cancer Consortium (AJCC) and the International Union Against Cancer The AJCCTNM staging system (UICC) has been widely recognized and applied. It is an anatomical staging method with characteristics of primary tumor (T), regional lymph node (N), and distant metastasis (M). It also considers some important prognostic factors. The surgeon should work with the pathologist to discuss the stage for the development of breast cancer and colon cancer as an example: (a) Breast cancer; T - Determination of the maximum diameter of a breast mass, <2 cm For T 1 period, it is further divided into three phases of T_(la) (<0.5cm), T_(lb) (0.5~1cm), and T_(lc) (1~2cm); >2~5cm is T_2; >5cm is T_3. Period; tumor invasion of the thymus outside the T_4 period, and then divided into T_ (4a) (infringement of the chest wall), T_ (4b) (invasion of the skin, such as the presence of edema, ulcers, satellite nodules or orange peel sign, skin fixation or nipple retraction exception ), T_ (4c) phase (invading the chest wall and skin) and T_ (4d) phase (mammary inflammatory cancer). N - divided into N_0 (no axillary lymph node metastasis), N_1 (axillary lymph node metastasis) , activity), N 2 (axillary lymph node metastasis, fixation) and N_3 (ipsilateral intramammary lymph node metastasis), supraclavicular lymph node metastasis are classified as M_1.