中国实用外科杂志

中国实用外科杂志

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美国癌症联合委员会胆道恶性肿瘤分期系统（第8版）更新解读

汤朝晖1，田孝东2，魏妙艳1，王维民2，全志伟1   

  1. 1 上海交通大学医学院附属新华医院普外科，上海 200092；2北京大学第一医院普通外科，北京 100034
  • 出版日期:2017-03-01 发布日期:2017-03-02

  • Online:2017-03-01 Published:2017-03-02

摘要：

美国肿瘤联合委员会（AJCC）的癌症分期系统是确定肿瘤分期、个体化地选择治疗方案、判断病人预后、比较治疗效果的重要基础。AJCC第8版癌症分期系统将于2018-01-01在全球启动使用，为肿瘤诊治提供新的推荐意见。本次更新首次引入了AJCC证据等级（AJCC levels of evidence），用以指导临床医生在临床实践中正确理解分期系统。胆道恶性肿瘤（肝内胆管癌、胆囊癌、肝门部胆管癌、远端胆管癌和Vater壶腹癌）分期更新主要体现在细分、精确原发肿瘤（T）和局部淋巴结（N）的定义，更加强调临床实用性和可重复性，更加侧重客观指标的应用，肿瘤分期更能体现其对预后判断的价值。

关键词: 美国癌症联合委员会, 胆道恶性肿瘤, 癌症分期系统

Abstract:

Updates and interpretations of  the 8th edition of AJCC cancer staging system for biliary tract carcinoma                        TANG Zhao-hui*, TIAN Xiao-dong, WEI Miao-yan, et al.*Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Corresponding author: TANG Zhao-hui, E-mail: tangzhaohui@xinhuamed.com.cn
Abstract    The AJCC Cancer Staging system is an important foundation of identifying tumor staging，deciding individualized treatment option，predicting the prognosis and comparing the effectiveness of treatment. The AJCC 8th edition will become the new global guideline for cancer diagnosis and treatment from January 1, 2018. This edition cites the AJCC Levels of Evidence for the first time, which guide physicians to understand stage system more accurately. In the staging system for biliary tract (intrahepatic bile duct, gallbladder, perihilar bile ducts, distal bile duct and ampulla of Vater) carcinoma, the updates of 8th edition placing particular emphases on precise definition of primary tumor (T) and regional lymph nodes (N) , practicability and repeatability of clinical practice, application of objective indicators and prognostic evaluation based on stage. We interpret the new staging system and make further discussion about the updates.

Key words: American Joint Committee on Cancer, biliary tract carcinoma, cancer staging system