关键词: 美国癌症联合委员会, 壶腹部癌, 分期, 病理学

Abstract:

The guidance of the 8th edition of AJCC staging on pathology sampling and reporting for the ampullary cancer        WEI Shu-mei，XU Xiao-ming, SONG Kai, et al.
Department of Pathology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang Provincial Key Innovation Team of Pancreatic Cancer Diagnosis and Treatment (2013TD06), Hangzhou 310009, China
Corresponding author: WEI Shu-mei, E-mail:autumn200327@aliyun.com
Abstract    The recently published 8th edition of American Joint Committee of Cancer(AJCC) staging for ampullary cancer has made dramatic changes in the T and N staging. Quantification of the invasion depth is required for the T staging and N has been subdivided into N1 and N2 based on the number of positive lymph nodes.  Standardization of pathology sampling and reporting is demanded. For the precise staging, adequate exposure and fixation of the ampullary region before sampling is a critical step. It is important to take the sections parallel to the common bile and perpendicular to the ampullary mucosa, with an interval of 0.5 cm, to make sure that the ampullary region, pancreas and duodenum on the same plane. At least 12 lymph nodes are required. The pathology report should provide information regarding the specimen type, the position, size, differentiation, histopathology, infiltration, margin, lymph node metastasis, vasculature involvement and the results of specialized staining of the tumor. These updates are based on novel evidence, emphasizing the importance of the measurable objective parameters, reflecting the deeper understanding on ampullary cancer.

Key words: American Joint Committee on Cancer, ampullary cancer, staging, pathology