第九版肺癌TNM分期系统:精细分期指导精准诊疗  

The ninth edition of TNM staging for lung cancer:precise staging for precise diagnosis and treatment

作　　者：李函玥 王奕洋 刘慧[2] 刘宏旭[3] 姜丽岩[4] 韩昱晨 周文勇 茅腾[1] 方文涛[1] Li Hanyue;Wang Yiyang;Liu Hui;Liu Hongxu;Jiang Liyan;Han Yuchen;Zhou Wenyong;Mao Teng;Fang Wentao(Department of Thoracic Surgery,Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Radiotherapy,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Department of Thoracic Surgery,Liaoning Provincial Cancer Hospital,Shenyang 110801,China;Department of Pulmonary Medicine,Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Pathology,Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属胸科医院胸外科,上海200030 [2]中山大学肿瘤防治中心放疗科,广州510060 [3]辽宁省肿瘤医院胸外科,沈阳110801 [4]上海交通大学医学院附属胸科医院呼吸内科,上海200030 [5]上海交通大学医学院附属胸科医院病理科,上海200030

出　　处：《中华外科杂志》2024年第6期537-542,共6页Chinese Journal of Surgery

基　　金：上海申康医院发展中心三年行动计划(SHDC2020CR1023B)。

摘　　要：TNM分期系统是肿瘤诊断、治疗和研究的通用分期系统。肺癌第9版TNM分期系统已在2023年世界肺癌大会公布,并于2024年1月1日起施行。第9版分期系统的改动重点包括两点:将N2期细分为N2a期和N2b期,将M1c期分为M1c1期和M1c2期。T分期虽未发生更改,但验证了第8版T分期的有效性。N2期的细分使部分第8版分期系统的ⅢA期患者发生升期或降期,有助于更准确地评估纵隔淋巴结转移患者的病情和预后;M1c分期的改动则有助于未来准确定义寡转移和探索新型治疗模式。第9版分期系统更细致地划分了不同的肿瘤负荷,但未对新辅助治疗后的肺癌分期作出明确说明,未来仍需相关数据的补充。The ninth edition of TNM staging for lung cancer has been announced at the 2023 World Lung Cancer Congress and implemented from January 1,2024.The focus of the ninth TNM staging change is dividing N2 into N2a and N2b,as well as M1c into M1c1 and M1c2.Although the T staging has not changed,it has played an important role in verifying the eighth edition of the T staging.The subdivision of stage N2 has led some patients with ⅢA of the eighth edition to experience ascending or descending stages,which will more accurately help to assess the condition and prognosis of patients with mediastinal lymph node metastasis,as well as the design of related clinical studies.Modifying the M1c staging will help define oligometastasis and explore new treatment models in the future.The ninth edition of the TNM staging system provides a more detailed division of different tumor loads,but there is no clear explanation for the staging of lung cancer after neoadjuvant therapy.Further data analysis is needed,and it is expected to be answered in the tenth edition of TNM staging.

关 键 词：肺肿瘤 肿瘤分期 精准医学 肿瘤 淋巴结 远处转移 

分 类 号：R734.2[医药卫生—肿瘤]