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| 新肺癌分期系统 |
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| The New Lung Cancer Staging System |
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| Detterbeck FC, Boffa DJ, Tanoue LT 2009/12/31 9:38:00 |
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| Chest, 2009, |
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| View at Publisher |
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The International Association for the Study of Lung Cancer (IASLC) has conducted an extensive initiative to inform the revision of the lung cancer staging system. This involved development of an international database along with extensive analysis of a large population of patients and their prognoses. This article reviews the recommendations of the IASLC International Staging Committee for the definitions for the TNM descriptors and the stage grouping in the new non-small cell lung cancer staging system (Table 3).
| Descriptors |
Definitions |
Subgroups* |
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| T |
Primary tumor |
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| T0 |
No primary tumor |
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| T1 |
Tumor≤3cm,† surrounded by lung or visceral pleura,
not more proximal than the lobar bronchus |
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| T1a |
Tumor≤2cm† |
T1a |
| T1b |
Tumor>2 but ≤ 3cm† |
T1b |
| T2 |
Tumor>3 but ≤ 7cm† or tumor with any of the following‡: |
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Invades visceral pleura, involves main bronchus ≥2cm
distal to the carina, atelectasis/obstructive pneumonia
extending to hilum but not involving the entire lung |
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| T2a |
Tumor>3 but ≤ 5cm† |
T2a |
| T2b |
Tumor>5 but ≤ 7cm† |
T2b |
| T3 |
Tumor>7cm; |
T3>7 |
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or directly invading chest wall, diaphragm, phrenic nerve,
mediastinal pleura, or parietal pericardium; |
T3Inv |
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or tumor in the main bronchus < 2cm distal to the carina§; |
T3Centr |
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or atelectasis/obstructive pneumonitis of entire lung; |
T3Centr |
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or separate tumor nodules in the same lobe |
T3Satell |
| T4 |
Tumor of any size with invasion of heart, great vessels, trachea,
recurrent laryngeal nerve, esophagus, vertebral body, or carina; |
T4Inv |
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or separate tumor nodules in a different ipsilateral lobe |
T4Ipsi Nod |
| N |
Regional lymph nodes |
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| N0 |
No regional node metastasis |
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| N1 |
Metastasis in ipsilateral peribronchial and/or perihilar lymph nodes
and intrapulmonary nodes, including involvement by direct extension |
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| N2 |
Metastasis in ipsilateral mediastinal and/or subcarinal lymph nodes |
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| N3 |
Metastasis in contralateral mediastinal, contralateral hilar,
ipsilateral or contralateral scalene, or supraclavicular lymph nodes |
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| M |
Distant metastasis |
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| M0 |
No distant metastasis |
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| M1a |
Separate tumor nodules in a contralateral lobe; |
M1aContr Nod |
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or tumor with pleural nodules or malignant pleural dissemination‖ |
M1aPl Dissem |
| M1b |
Distant metastasis |
M1b |
Special
situations |
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| TX, NX, MX |
T, N, or M status not able to be assessed |
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| Tis |
Focus of in situ cancer |
Tis |
| T1§ |
Superficial spreading tumor of any size but
confined to the wall of the trachea or mainstem bronchus |
T1SS |
Table 3: Definitions for T, N, M Descriptors
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 疾病资源中心
病例分析 [栏目介绍]
王燕燕 王曙
上海交通大学附属瑞金医院内分泌科
患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
医学数据库
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