Department of Thoracic Medicine, The Prince Charles Hospital, The University of Queensland, Brisbane, Queensland, Australia.
Respirology. 2012 Feb;17(2):247-60. doi: 10.1111/j.1440-1843.2011.02083.x.
The Tumour, Node, Metastasis (TNM) system for classifying lung cancer is the cornerstone of modern lung cancer treatment and underpins comparative research; yet is continuously evolving through updated revisions. The recently published Union for International Cancer Control 7th Edition TNM Classification for lung cancer addresses many of its predecessor's shortcomings and has been subject to rigorous evidence-based methodology. It is based on a retrospective analysis of over 80 000 lung cancer patients treated between 1990 and 2000 carried out by the International Association for the Study of Lung Cancer. The dataset was truly international and included patients treated by all modalities. Extensive internal and external validation of the findings has ensured that the recommendations are robust and generalizable. For the first time, a single classification system has been shown to be applicable not only to non-small cell lung cancer, but also to be of prognostic significance in small cell lung cancer and bronchopulmonary carcinoid tumours. We review the history of the Union for International Cancer Control TNM staging system, the changes in the most recent 7th edition and the strength of the scientific basis motivating these changes. Limitations of the current staging edition are explored, post-publication independent validation studies are reviewed, and the future of TNM staging for lung cancer is discussed.
用于肺癌分类的肿瘤、淋巴结、转移（TNM）系统是现代肺癌治疗的基石，也是比较研究的基础；然而，它通过不断更新的修订版持续发展。最近公布的国际抗癌联盟第 7 版 TNM 肺癌分类解决了其前身的许多缺点，并经过了严格的循证方法学的检验。它基于国际肺癌研究协会对 1990 年至 2000 年间治疗的 80000 多名肺癌患者的回顾性分析。该数据集是真正的国际性的，包括所有治疗方式的患者。对这些发现进行了广泛的内部和外部验证，以确保建议是稳健且可推广的。这是第一次，一个单一的分类系统不仅适用于非小细胞肺癌，而且对小细胞肺癌和支气管肺类癌肿瘤也具有预后意义。我们回顾了国际抗癌联盟 TNM 分期系统的历史，最近第 7 版的变化以及推动这些变化的科学基础的强度。探讨了当前分期版本的局限性，回顾了出版后的独立验证研究，并讨论了肺癌 TNM 分期的未来。
