【资源】2002年AJCC癌症分期----肺癌(E)

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2002年AJCC癌症分期----肺癌
      
       【TNM Definitions】
      Primary tumor (T)

      TX: Primary tumor cannot be assessed, or tumor is proven by the presence
      of malignant cells in sputum or bronchial washings but is not visualized
      by imaging or bronchoscopy

      T0: No evidence of primary tumor

      Tis: Carcinoma in situ

      T1: A tumor that is ≤3 cm in greatest dimension, is surrounded by lung or
      visceral pleura, and is without bronchoscopic evidence of invasion more
      proximal than the lobar bronchus (i.e., not in the main bronchus).

      Note: The uncommon superficial tumor of any size with its invasive
      component limited to the bronchial wall, which may extend proximal to the
      main bronchus, is also classified as T1.

      T2: A tumor with any of the following features of size or extent:
        >3 cm in greatest dimension
        Involves the main bronchus and is ≥2 cm distal to the carina
        Invades the visceral pleura
        Associated with atelectasis or obstructive pneumonitis that extends to  the hilar region but does not involve the entire lung

      T3: A tumor of any size that directly invades any of the following: chest
       wall (including superior sulcus tumors), diaphragm, mediastinal pleura,
      parietal pericardium; or, tumor in the main bronchus <2 cm distal to the
      carina but without involvement of the carina; or, associated atelectasis
      or obstructive pneumonitis of the entire lung

      T4: A tumor of any size that invades any of the following: mediastinum,
      heart, great vessels, trachea, esophagus, vertebral body, carina; or,
      separate tumor nodules in the same lobe; or, tumor with a malignant
      pleural effusion.

      Note: Most pleural effusions associated with lung cancer are due to tumor;
      however, in a few patients multiple cytopathologic examinations of pleural
      fluid are negative for tumor. In these cases, fluid is nonbloody and is
      not an exudate. Such patients may be further evaluated by
      videothoracoscopy and direct pleural biopsies. When these elements and
      clinical judgment dictate that the effusion is not related to the tumor,
      the effusion should be excluded as a staging element, and the patient
      should be staged as T1, T2, or T3.

      Regional lymph nodes (N)
      NX: Regional lymph nodes cannot be assessed
      N0: No regional lymph node metastasis
      N1: Metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph
      nodes, and intrapulmonary nodes including involvement by direct extension
      of the primary tumor
      N2: Metastasis to ipsilateral mediastinal and/or subcarinal lymph node(s)
      N3: Metastasis to contralateral mediastinal, contralateral hilar,
      ipsilateral or contralateral scalene, or supraclavicular lymph node(s)


      Distant metastasis (M)
      MX: Distant metastasis cannot be assessed
      M0: No distant metastasis
      M1: Distant metastasis present. Note: M1 includes separate tumor nodule(s)
      in a different lobe (ipsilateral or contralateral).

【Stage Groupings】
      Occult carcinoma
        TX, N0, M0

      Stage 0
        Tis, N0, M0

      Stage IA
        T1, N0, M0

      Stage IB
        T2, N0, M0

      Stage IIA
        T1, N1, M0

      Stage IIB
        T2, N1, M0
        T3, N0, M0

      Stage IIIA
        T1, N2, M0
        T2, N2, M0
        T3, N1, M0
        T3, N2, M0

      Stage IIIB
        Any T, N3, M0
        T4, any N, M0

      Stage IV
        Any T, any N, M1

【Stage Notes】
      Occult (hidden) stage

      In the occult (hidden) stage, cancer cells are found in sputum (mucus
      coughed up from the lungs), but no tumor can be found in the lung by
      imaging or bronchoscopy, or the primary tumor is too small to be assessed.

      Stage 0 (carcinoma in situ)
      In stage 0 (carcinoma in situ), cancer is limited to the lung and is found
      only in a few layers of cells. It has not grown through the top lining of
      the lung.

      Stage I
      In stage I, the cancer is in the lung only, with normal tissue around the
      tumor. Stage I is divided into stages IA and IB, based on the size of the
      tumor.

      Stage II
      In stage II, cancer has spread to nearby lymph nodes or to the chest wall
      (the ribs and muscles that make up the area of the body between the neck
      and the abdomen), the diaphragm (the thin muscle below the lungs and heart
      that separates the chest from the abdomen), the mediastinal pleura (the
      thin membrane that covers the outside of the lungs in the area near the
      heart), or the parietal pericardium (the outer layer of tissue that
      surrounds the heart). Stage II is divided into stage IIA and stage IIB,
      based on the size of the tumor and whether it has spread to the lymph
      nodes.

      Stage III
      In stage III, cancer has either:
        spread to the lymph nodes in the mediastinum (the middle area between
      the lungs that contains the heart, major blood vessels, and other
      structures); or
        spread to the lymph nodes on the opposite side of the chest or in the
      lower neck.
      Stage III is divided into stage IIIA (which is sometimes treated with
      surgery) and stage IIIB (which is rarely treated with surgery).

      Stage IV
      In stage IV, cancer has spread to other parts of the body or to another
      lobe of the lungs.

[ 本帖最后由 flk107 于 2006-10-28 23:46 编辑 ]