关于唾液腺癌第九版AJCC/UICC分期系统的关键更新
Shao Hui Huang1, Raja R Seethala2, Snehal G Patel3
1Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada. shaohui.huang@uhn.ca.
Annals of surgical oncology
|March 5, 2026
概括
第九版瘤结节转移 (TNM9) 分类统一了主要和小唾液腺癌 (SGC) 的分期. 这一修订后的系统提高了SGC患者的预后准确性和临床管理.
科学领域:
- 在瘤学瘤学.
- 头部和部手术 头部和部手术
- 癌症的分期 癌症的分期
背景情况:
- 现有的第八版瘤结节转移 (TNM8) 分类对主要唾液腺癌 (SGC) 结节分期有局限性.
- 较小的SGC被按地点进行,忽视了不同的生物学和传播模式,需要一个统一的系统.
研究的目的:
- 开发和验证一个完善的,统一的TNM分类系统,用于主要和小的唾液腺癌.
- 解决以前分阶段系统的缺陷,改善预后歧视.
主要方法:
- 一个多学科的国际专家小组与美国癌症联合委员会 (AJCC) 的头部和部核心小组合作.
- 该小组开发并验证了SGC的精细TNM分类,随后由AJCC和UICC采用.
主要成果:
- 第九版 (TNM9) 引入了首个统一的SGC特定分期系统,用于主要和次要SGC.
- 关键的修订包括排除罕见组织学,整合大/小SGC,简化N分类 (N0-N2基于节点数和节外延伸),并限制第四阶段到M1疾病.
- 临床TNM (cTNM) 标准与病理TNM (pTNM) 保持一致,包括淋巴结数的放射性评估和成像检测的外节延伸 (iENE).
结论:
- TNM9为SGCs建立了一个统一的,生物相关的分期系统.
- 修订后的系统提供了更好的预后歧视,提高了临床适用性,并促进了主要和小唾液腺癌的一致管理.
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