8th Edition Tumor, Node, and Metastasis T-Stage Prognosis Discrepancies: Solid Component Diameter Predicts Prognosis Better than Invasive Component Diameter
8th Edition Tumor, Node, and Metastasis T-Stage Prognosis Discrepancies: Solid Component Diameter Predicts Prognosis Better than Invasive Component Diameter
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DOI：
10.3390/cancers12061577
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发表时间：
2020-06-01
期刊：
影响因子：
5.2
通讯作者：
Shiiya, Norihiko
中科院分区：
文献类型：
--
作者：
Funai, Kazuhito;Kawase, Akikazu;Shiiya, Norihiko
第8版肿瘤、淋巴结和转移（TNM）分类的最大变化是分别推荐用于确定临床和病理T因子的实体成分直径和浸润尺寸。在这里，我们验证了肺癌TNM分类修订的新建议，并比较了临床和病理T分期。我们回顾性分析了2017年1月至2019年3月期间在我科发生的177例无淋巴结转移且涉及完全切除的非小细胞肺癌病例。我们回顾了肿瘤的总体直径、实体成分直径和CT上的临床T因子，以及病理肿瘤直径、病理浸润直径、病理T因子和预后。99例（56%）的病灶大小与CT上的实性病灶大小相差在5mm以内。在两年无复发生存率方面，临床T分期比病理T分期显示出更好的预后结果。尽管包括良性病变，实性成分直径与预后的相关性优于浸润性大小。因此，在临床和病理检测到的肿瘤大小不一致的情况下，实体CT大小也应用于病理T分类。
The biggest change in the 8th edition of the tumor, lymph node, and metastasis (TNM) classification is the recommendation of the solid component diameter and invasive size for determining the clinical and pathological T-factor, respectively. Here, we validated new proposals for the Lung Cancer TNM classification's revision and compared clinical and pathological T-stages. We retrospectively analyzed 177 cases of non-small cell lung cancers without lymph node metastasis, and involving complete resection, that occurred in our department between January 2017 and March 2019. We reviewed the overall tumor diameter, solid component diameter, and clinical T-factor on computed tomography (CT), and the pathological tumor diameter, pathological invasion diameter, pathological T-factor, and prognosis. The difference between the pathological invasive size and solid size on CT was within 5 mm in 99 cases (56%). At a two-year recurrence-free survival rate, the clinical T-stage demonstrated a better prognostic outcome than the pathological T-stage. Despite including the benign findings, the solid component diameter was better correlated with prognosis than the invasive size. Therefore, in cases of discrepancies of clinically and pathologically detected tumor size, the solid CT size should also be used for the pathological T classification.