摘要
胃癌TNM分期已经成为胃癌临床治疗决策的选择和预后判断的重要参考依据。第七版胃癌TNM分期系统于2009年出版并于2010年实施。但是，在第七版胃癌分期系统临床应用过程中。发现其存在一定的不足，使得该分期系统已经不能满足临床诊疗需求。因此，在美国癌症联合委员会（AJCC）、国际抗癌协会（UICC）和国际胃癌协会（IGCA）的共同协作和推动下．通过胃癌大数据的积累和分析，于2016年底出版了第八版胃癌TNM分期系统。新的分期系统明确定义了胃食管结合部癌选择食管癌TNM分期标准还是胃癌TNM分期标准。将N3期细分成N3a期和N3b期，并将其纳入了TNM分期系统，使得新版的分期更加精确，更能反应真实的胃癌预后情况。此外，新版TNM分期系统还新增了胃癌临床TNM（cTNM）分期标准和新辅助治疗后TNM（ypTNM）分期标准。总之，第八版胃癌TNM分期系统可以指导医生制定更加合理的治疗方案，更为科学地评价治疗方案的疗效，同时有助于预后评估的准确性。对推动胃癌诊疗水平的提高有重要指导价值。
TNM staging is essential for clinical decision-making and prognostic prediction for patients with gastric cancer. The 7th TNM staging manual was formulated in 2009 and implemented in 2010. However, it was published that there were some deficiencies of the 7th edition of gastric cancer TNM staging system in clinical application process, and this old staging system could not meet the clinical needs. With the cooperation and promotion of the American Joint Committee on Cancer （AJCC）, the International Union for Cancer Control （UICC） and the International Gastric Cancer Association （IGCA）, and through the accumulation and analysis of gastric cancer big data, the 8th TNM staging system was published at the end of 2016. The updated staging system has defined the selection of staging system for esophagogastric junction cancer. It also has divided N3 into N3a and N3b, which has been incorporated into the new staging system, leading to more accurate risk stratification. Moreover, the eTNM staging system and ypTNM staging system have been added in the new staging manual. Overall, the 8th TNM staging system can facilitate more reasonable decision-making, more accurate prognostic prediction and better evaluation of therapeutic strategy. It is of high value to promote diagnostic and therapeutic standard for gastric cancer.
作者
郗洪庆
张珂诚
卫勃
陈凛
Xi Hongqing Zhang Kecheng Wei Bo Chen Lin(Department of General Surgery, Chinese People＇s Liberation Army General Hospital, Beijing 100853, China)
出处
《中华胃肠外科杂志》
CAS
CSCD
北大核心
2017年第2期166-170,共5页
Chinese Journal of Gastrointestinal Surgery
基金
解放军总医院医疗大数据研发项目（2016MBD-012）
北京市科技计划课题（Z161100000516237）
关键词
胃肿瘤
肿瘤分期
TNM分期
Stomach neoplasms
Tumor staging system
TNM Stage
