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美国肿瘤联合会乳腺癌分期系统（第8版）更新内容介绍及解读

周    斌1a，季    科2，辛    灵1a，张    虹1b，徐    玲1a，李    挺1b，刘荫华1a   

  1. 1北京大学第一医院   a.外科  b.病理科，北京100034；2北京大学肿瘤医院胃肠外科，北京100142
  • 出版日期:2017-01-01 发布日期:2017-01-03

  • Online:2017-01-01 Published:2017-01-03

摘要：

自1977年美国肿瘤联合会（AJCC）制定第1版癌症分期系统至今已历经40年和8个版本的更新。其中，坚持以解剖学原发肿瘤（T），淋巴结（N）及转移灶（M）信息为基础对肿瘤分期进行评价是一贯的基本原则。本次乳腺癌分期系统更新内容包括：首次建立解剖学分期与预后分期理念；重新解释和细化T、N、M定义；在基础研究结论和大数据总结的基础上，大幅度增加非解剖学信息对预后进行评价是本次分期系统更新最重要的亮点，其中，首次以I类证据推荐适应证人群选择Oncotype Dx®多基因检测。全新的分期系统不仅推动了癌症分期从宏观解剖到微观基因组学的进步，也实现了个体化医疗从理论到实践的巨大转变。

关键词: 乳腺癌, 美国肿瘤联合会, 癌症分期系统

Abstract:

Updates and interpretations of the 8th edition of AJCC breast cancer staging system        ZHOU Bin※，JI Ke,XIN Ling,et al. ※Department of Surgery,Peking University First Hospital,Beijing100034,China
Corresponding author: LIU Yin-hua, E-mail: liuyinhua@
medmail.com.cn
Abstract    It has been 40 years since the publication of 1st edition of AJCC cancer staging system, and there has been 8 editions. The consistent fundamental principle is insisting that the combination of primary tumor (T), regional lymph nodes (N) and metastases （M） is the cornerstone of cancer staging. Updates of 8th edition of breast cancer staging system include building up both Anatomic Stage Group and Prognostic Stage Group for the first time, redefining and detailing the definitions of T, N, M, and adding a large number of non-anatomical factors into prognostic evaluation, which is the highlight of this edition. The 8th edition staging system recommends that Oncotype Dx® MultiGene Panel should be used in appropriate patient population for the first time. The new staging system not only accelerates the progress of cancer staging system from level of macroanatomy to genomics, but also realizes the transformation of personalized medicine from theory to practice.

Key words: breast cancer, American Joint Committee on Cancer, cancer staging system