In January 2018, differentiated thyroid cancer adopted a new stage method
from AJCC version 7 to 8th version
It sounds like it has nothing to do with you at first
, but if you say that the survival rate of atarctic cancer is linked to stage
, you will think: Hey, installment is still very important!
installment looks simple
There are many people who make mistakes
For example, this article 10W+ reading popular science
The first message said that I am thyroid cancer 3
can be as follows:
is not papillary cancer or stage 4a medullary cancer
I don’t know if it’s her own misunderstanding
or was seriously explained
This period will talk about the stage of thyroid papillary carcinoma and follicular carcinoma
TNM definition
TNM stage is the recognized standard of the earth
T (Tumor) represents the primary tumor
N (Node) represents regional lymph node metastasis
M (Metastasis) represents distant metastasis
1 T stage
T stage depends on the size of the primary tumor and whether there is thyroid external invasion
T1, T2, T3a, indicates that the tumor is still in the thyroid
T3b, T4a, T4b means that the tumor has invaded the outside of the thyroid
. It should be noted that
. The invasion here refers to the invasion visible to the naked eye
. It is not an invasion under the microscope. tml1
T1: The primary tumor is less than 2 cm
T2: The primary tumor is 2-4 cm
T3a: The primary tumor is more than 4 cm
T3b: The primary tumor invades muscle tissue outside the thyroid
T4a: The primary tumor invades key tissue outside the thyroid, such as the trachea, esophagus, recurrent laryngeal nerve, laryngeal, subcutaneous soft tissue
T4b: The primary tumor cannot be removed due to large-scale invasion
2 Stage of N
N staging of N depends on whether lymph nodes are metastatic and the location of metastatic
N0: Lymph nodes do not metastasize
N1a: Lymph nodes are metastatic to the central area (para trachea, pretrachea, pre-ladder)
N1b: Lymph nodes are metastatic to the lateral cervical area (zone 1-5) and posterior pharyngeal
3 M stage
M stage staging is based on whether there is distant metastasis as the standard
M0: No distant metastasis
M1: There is distant metastasis
TNM stage
TNM number after the number after
TNM is determined
tumor is divided into stage 1234
interestingly,
differentiated thyroid cancer (papillary carcinoma, follicular carcinoma) is the only tumor linked to stage and age
1
The age of diagnosis is less than 55 years old
There is no distant metastasis all stage 1
combined with distant metastasis is stage 2
This is why young patients with thyroid cancer have few deaths
Even if the diagnosis is large-scale metastasis
Tumor stage is only stage 2
2 55 years old
1
2 55 years old
1
2 55 years old
2 55 years old diagnosing age is more than 55 years old:
The staging of tumors is related to the data behind TNM
This is why older patients have
metastasis to a certain extent and affect the prognosis. For specific staging, see the table below
Changes in new staging
Compared with the previous version, what changes are there in the new version?
First, the age dividing line has increased from 45 years old to 55 years old
Second, some patients have T and N stages downgraded
Finally, even with the same TNM number, the actual stages of older patients (1-4 stages) are downgraded
These changes have caused many patients to degrade
Take the data from Anderson Tumor Center as an example:
Thyroid, 2018, 28, 2010, The proportion of patients with stage 1301-1310
1 increased from 62% to 83%
2 patients increased from 5% to 12%
3 patients decreased from 20% to 2%
4 patients decreased from 14% to 3%
0 stages, while the corresponding survival rate also decreased
1 period ten-year survival rate dropped from 100% to 99.8%
2 period ten-year survival rate dropped from 97.5% to 88.3%
3 period ten-year survival rate dropped from 98.3% to 72.4%
4 period ten-year survival rate dropped from 82.6% to 71.9%
Simply put, the new installment system has widened the survival rate difference in each period
