第8版国际抗癌联盟和美国癌症联合委员会胃癌TNM分期系统简介及解读

目前胃癌的TNM分期已经成为临床胃癌诊疗的首选参考依据。在国际抗癌联盟(UICC)、国际胃癌协会(IGCA)和美国癌症联合委员会(AJCC)的共同协作推动下,通过对全世界范围内胃癌大数据的收集与分析,于2016年10月颁布了第8版胃癌TNM分期系统。第8版TNM分期系统对食管-胃结合部及贲门癌分期标准的选择做出了明确的定义;同时还在单一分期系统的基础上新增了临床TNM分期(cTNM)和新辅助治疗后分期(ypTNM)。此外,新版的分期系统将N3的两个亚组N3a和N3b作为独立组别纳入到分期系统,还对组织学分级进行了一些调整。总的来说,相比第7版胃癌TNM分期系统,新版的分期系统可以指导临床医生更加合理地制定治疗方案,更加科学地评价治疗效果,更加准确地评估预后。然而,随着临床广泛应用和进一步验证,以及新的预测因子的发现,必将会有新的分期系统替代和完善旧的分期系统。

The 8th edition of the Union for International Cancer Control and the American Joint Committee on Cancer gastric cancer TNM staging system: explanation and elaboration

The TNM stage of gastric cancer has become the first reference for clinical diagnosis and treatment of gastric cancer.Through the collection and analysis of data on gastric cancer worldwide,the Union for International Cancer Control (UICC),International Gastric Cancer Association (IGCA) and American Joint Committee on Cancer (AJCC) jointly issued the 8th edition of the gastric cancer TNM staging system,in October 2016.The 8th edition of the TNM staging system has a clear definition of the staging criteria for esophago-gastric junction cancer and cardia cancer,and adds clinical TNM staging (cTNM) and new adjuvant therapy (ypTNM) on the basis of a single stage system.In addition,the new staging system incorporates two subgroups of N3 (N3a and N3b) as independent group into the system,and makes some adjustments to the histological grade.In general,compared with the 7th edition of gastric cancer TNM staging system,the new edition of staging system may guide clinicians more rational treatment,more scientific evaluation of treatment effect,more accurate assessment of the prognosis for gastric cancer patients.However,with the widespread clinical application and further validation,as well as the discovery of new predictors,there will be new staging systems to replace and refine the old staging system.