肺癌國際分期

1、12 歷史背景：歷史背景： 19461946： denoix denoix 提出提出 tnm tnm 分期系統(tǒng)分期系統(tǒng) 19761976： uicc uicc 制定第一個(gè)肺癌國際分期制定第一個(gè)肺癌國際分期 19861986： uicc/ajcc uicc/ajcc 新的肺癌國際分期新的肺癌國際分期 19971997： uicc/ajcc uicc/ajcc 修訂肺癌國際分期修訂肺癌國際分期34 5678 9101112 1314 15161718192021222324lung cancerstage i diseaselung cancerstage i disease 2 2 cmcmor

2、orororn0: no lymph node involvementn0: no lymph node involvementno lobarno lobarbronchusbronchusinvolvementinvolvementt t 3 cm 3 cm stage iastage iat1t1n0n0m0m0 stage ibstage ibt2t2n0n0m0m0t t 3 cm3 cmt + visceral pleurat + visceral pleurainvolvedinvolvedt +t + atelectasis atelectasis2526lung cancer

3、stage ii diseaselung cancerstage ii disease 2 2 cmcmorororor n1: intrapulmonary and/orn1: intrapulmonary and/or hilar hilar nodes involved nodes involvedno lobarno lobarbronchusbronchusinvolvementinvolvementt t 3 cm 3 cm stage iiastage iiat1t1n1n1m0m0 stage ii bstage ii bt2t2n1n1m0m0t3 t3 n0 m0 n0 m

4、0t t 3 cm3 cmt + visceral pleurat + visceral pleurainvolvedinvolvedt +t + atelectasis atelectasis27lung cancerstage iiia diseaselung cancerstage iiia disease 2 2 cm 2 cmt2t2orororororororort1t1n1:n1: peribronchial peribronchial or or ipsilateral hilar ipsilateral hilart t 3 cm 3 cmno lobarno lobarbr

5、onchus involvementbronchus involvementt t mediastinal mediastinal pleura pleura (or pericardium) (or pericardium)t t chest wall chest wall (or diaphragm) (or diaphragm)t3t3n1n1m0m0t3t3n2n2m0m0t1 t1 n2n2m0m0t2t2n2n2m0m0t t 3 cm 3 cmt + visceral pleurat + visceral pleurainvolvedinvolvedt +t + atelecta

6、sis atelectasisn2:n2: ipsilateral mediastinal ipsilateral mediastinal and and subcarinal subcarinal28 任何任何t任何任何n m129lung cancerstage iiib diseaselung cancerstage iiib diseaseany t, n3, m0any t, n3, m0any n, t4, m0any n, t4, m0scalenescalenesupraclavicularsupraclavicularn3: lymph nodes involvedn3: lymph nodes involvedt4:t4: mediastinal mediastinal involvement involvementany tany tany nany nt4t430lung cancerlocal and distal spreadlung cancerlocal and distal sprea