美国癌症联合委员会第八版结直肠癌分期更新及其“预后和预测”评价体系
Improvement of prognostic and predictive network of colorectal cancer based upon the 8th edition of AJCC ;colorectal cancer staging system
摘要美国癌症联合委员会(AJCC)第八版癌症分期系统将于2018年1月1日在全球启用,其中结直肠癌分期系统最重要更新在于,增加了基于组织病理学和分子生物学的“非解剖学”预后和预测因素,以及在此基础上进一步完善的预后评估体系。AJCC第八版结直肠癌分期系统对获得Ⅰ~Ⅱ级证据支持的8个预后和(或)预测因素进行了推荐,包括血清CEA水平、肿瘤退缩评分、环周切缘、淋巴管血管侵犯、神经周围侵犯、微卫星不稳定、KRAS/NRAS基因突变及BRAF基因突变。在循证医学和精准医学的背景下,“解剖学”分期和“非解剖学”分类体系的联合使用,将有利于对结直肠癌进一步分期和分类诊治,有助于个体化评估结直肠癌患者预后风险并预测治疗疗效,推动结直肠癌临床实践从传统“群体化”诊治到精准“个体化”医疗的转变。
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abstractsThe 8th edition of AJCC cancer staging system will be launched all over the world in January 1 , 2018. The major advances in the 8th edition are the introduction of non-anatomic prognostic and predictive factors supported by Ⅰ-Ⅱ grade evidence based on histopathology and molecular biology, and the improvement of prognostic assessment system based on these factors , including CEA level, cancer retraction score, circumference margin, lymphatic invasion, peripheral nerve invasion, microsatellite instability, KRAS/NRAS gene mutation and BRAF gene mutation. In the background of evidence-based medicine and precise medicine, combination of anatomic staging and non-anatomic classification system is very important for establishing and improving the prognostic and predictive assessment system of colorectal cancer. This will help to assess colorectal cancer staging and grouping much better, evaluate the prognosis, predict individualized efficacy, and promote clinical practice of colorectal cancer from traditional population-based diagnosis and treatment to the precise individualized care.
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