肿瘤的TNM分期讲解(stage)

肿瘤的TNM分期讲解(stage)

TCGA数据库中临床数据的TNM分期,及病理分期如下:

submitter_idajcc_pathologic_najcc_pathologic_majcc_pathologic_stageajcc_pathologic_t
TCGA-3M-AB46N0MXStage IBT2b
TCGA-3M-AB47N2MXStage IIIBT3
TCGA-B7-5816N0M0Stage IIBT4a
TCGA-B7-5818N0M0Stage IBT2
TCGA-B7-A5TIN3M0Stage IIICT4
TCGA-B7-A5TJNXM0Stage IIBT4a
TCGA-B7-A5TKNAM0Stage IIIAT4
TCGA-B7-A5TNNXM0Stage IIBT4a
TCGA-BR-4183N1M0Stage IIIAT3
TCGA-BR-4184N1MXStage IIIAT3
TCGA-BR-4253N1M0Stage IIIAT3
TCGA-BR-4255N1M0Stage IIIAT3
TCGA-BR-4267N0M0Stage IBT2a
TCGA-BR-4279N1M0Stage IIT2a
TCGA-BR-4280N1M0Stage IIIT2b
TCGA-BR-4361N0M0Stage IIIAT4
TCGA-BR-4368N2M0Stage IVT4
TCGA-BR-6452N0M0Stage IIAT3
TCGA-BR-6453N1M0Stage IIAT2
TCGA-BR-6454N0M0Stage IIAT3
TCGA-BR-6455N1M0Stage IIBT3
TCGA-BR-6456N1M0Stage IIBT3
TCGA-BR-6457N0M0Stage IIAT3
TCGA-BR-6458N1M0Stage IIBT3
TCGA-BR-6563N1M0Stage IIBT3
TCGA-BR-6564N2M0Stage IIIAT3
TCGA-BR-6565N0M0Stage IIBT4a
TCGA-BR-6566N0M0Stage IIAT3
TCGA-BR-6705N3aM0Stage IIIBT3
TCGA-BR-6706N1M0Stage IIIAT3
TCGA-BR-6707N0M0Stage IIAT3
TCGA-BR-6709N3aM0Stage IIIBT3
TCGA-BR-6710N0M0Stage IBT2
TCGA-BR-6801N0M0Stage IIAT3
TCGA-BR-6802N2M0Stage IIIAT3
TCGA-BR-6803N0M0Stage IIAT3
TCGA-BR-6852N0M0Stage IIAT3
TCGA-BR-7196N3aM1Stage IVT3
TCGA-BR-7197N0M0Stage IIT3

下面给家介绍一下,具体的分期

Diagram showing the T stages of bladder cancer




Pathologic TNM staging of thymoma and related entities, AJCC 8th edition
Definition / general
  • Applicable to thymoma, thymic carcinoma, thymic neuroendocrine tumors, combined thymic carcinoma
  • First introduced in AJCC 8th edition (Amin: AJCC Cancer Staging Manual, 8th Edition, 2017)
  • AJCC/TNM staging is used for predicting outcomes of thymic tumors, such as recurrence (in the lower stages) and disease specific survival (in the higher stages); reference numbers are available (J Thorac Oncol 2014;9:S65)
  • Pre operative clinical staging is based on physical examination and imaging; post operative clinical staging may be supplemented by pathological findings
  • Stage is determined primarily by levels of local invasion of a thymic malignancy into surrounding mediastinal structures (T classification) while nodal involvement and metastatic spread are much rarer events
  • There is no recommended histologic grading system for thymic tumors
  • Other staging systems also exist (Lung Cancer 2014;83:126)
Essential features
  • T, N and M categories are the mainstay for predicting recurrence and survival in patients with thymic tumors
  • Local invasion (T category) is the primary determinant of staging
Primary tumor (T)
  • TX: primary tumor cannot be assessed
  • T0: no evidence of primary tumor
  • T1: tumor encapsulated or extending into the mediastinal fat, may involve the mediastinal pleura
  • T1a: tumor with no mediastinal pleura involvement
  • T1b: tumor with direct invasion of mediastinal pleura
  • T2: tumor with direct invasion of the pericardium (either partial or full thickness)
  • T3: tumor with direct invasion into any of the following: lung, brachiocephalic vein, superior vena cava, phrenic nerve, chest wall or extrapericardial pulmonary artery or veins
  • T4: tumor with invasion into any of the following: aorta (ascending, arch or descending), arch vessels, intrapericardial pulmonary artery, myocardium, trachea, esophagus

Notes:
  • Involvement must be microscopically confirmed in pathological staging, if possible
  • T categories are defined by levels of invasion; they reflect the highest degree of invasion regardless of how many other (lower level) structures are invaded
  • T1, level 1 structures: thymus, anterior mediastinal fat, mediastinal pleura
  • T2, level 2 structures: pericardium
  • T3, level 3 structures: lung, brachiocephalic vein, superior vena cava, phrenic nerve, chest wall, hilar pulmonary vessels
  • T4, level 4 structures: aorta (ascending, arch or descending), arch vessels, intrapericardial pulmonary artery, myocardium, trachea, esophagus
Regional lymph node (N)
  • NX: regional lymph nodes cannot be assessed
  • N0: no regional lymph nodes metastasis
  • N1: metastasis in anterior (perithymic) lymph nodes
  • N2: metastasis in deep intrathoracic or cervical lymph nodes

Note:
  • Involvement must be microscopically confirmed in pathological staging, if possible
Distant metastasis (M)
  • M0: no pleural, pericardial or distant metastasis
  • M1: pleural, pericardial or distant metastasis
  • M1a: separate pleural or pericardial nodule(s)
  • M1b: pulmonary intraparenchymal nodule or distant organ metastasis
AJCC prognostic stage grouping
Stage I:T1a, T1bN0M0
Stage II:T2N0M0
Stage IIIA:T3N0M0
Stage IIIB:T4N0M0
Stage IVA:any TN1M0
any TN0, N1M1a
Stage IVB:any TN2M0, M1a
any Tany NM1b
Board review question #1
A 62 year old man presented with a large thymic carcinoma directly invading pericardium and no metastatic spread. What is the pT category per the AJCC/TNM 8th edition?

  1. pT1a
  2. pT1b
  3. pT2
  4. pT3
  5. pT4
Board review answer #1
C. pT2
Board review question #2
What is the major predictor of thymic carcinoma recurrence?

  1. Distant metastasis
  2. Extent of local invasion
  3. Histological type
  4. Nodal metastasis
  5. Size of tumor




https://en.wikipedia.org/wiki/TNM_staging_system

更多:https://www.pathologyoutlines.com/topic/mediastinumthymomastaging.html


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  • 发表于 2019-11-29 13:19
  • 阅读 ( 2466 )
  • 分类:TCGA

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