Abstract:

Updates and interpretations of AJCC Cancer Staging Manual 8th edition for colorectal carcinoma        LIU Yin-hua※, YAO Hong-Wei, ZHOU Bin, et al. ※Department of General Surgery, Peking University First Hospital, Beijing
100034,China
Corresponding author: YAO Hong-Wei, E-mail:yaohongwei@
medmail.com.cn
Abstract    The AJCC Cancer Staging Manual, 8th edition will become the new global guideline for cancer diagnosis and treatment from January 1,2018.The new edition tumor staging system has enormous updates. In 2013, the AJCC 8th edition Evidence-Based Medicine and Statistics Core was formed to establish the level of evidence based on the quality of evidence, which provide a more scientific and objective reference for physicians to understand the recommendations. In the staging system for colorectal carcinoma, the updates include introduction of M1c and clarification of the concept of tumor deposits. Nonanatomic information that is clinically significant is included for collection, such as lymphovascular invasion and microsatellite instability. In addition, KRAS, NRAS and BRAF mutations are identified as critical prognostic factors and have been proved to be predictive.

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

摘要：

美国肿瘤联合会（AJCC）第8版癌症分期系统将于2018-01-01在全球启动使用，并为肿瘤诊治提供最新的意见推荐。本次系统更新内容众多，其中，2013年AJCC首次成立第8版分期循证医学与统计学核心组（AJCC 8th Edition Evidence-Based Medicine and Statistics Core），并组织建立了AJCC证据等级（AJCC Levels of Evidence）。该证据等级共分4级，所代表的证据质量由Ⅰ~Ⅳ级递减，其中证据质量Ⅰ~Ⅲ级的内容最终写入第8版分期系统。该证据等级的建立，为临床医生正确理解和应用分期系统推荐意见提供了科学客观的参考依据。AJCC第8版结直肠癌分期系统内容更新增加了远隔部位转移M1c分期定义；重申并澄清肿瘤沉积概念；同时，提出包括血管淋巴管浸润、微卫星不稳定性等信息应作为结直肠癌临床关注因素；明确KRAS、NRAS和BRAF突变是影响预后的关键因素，并对预后具有预测价值。

关键词: 美国肿瘤联合会, 结直肠癌, 癌症分期系统