验证 AJCC TNM 分期系统在癌症登记处 2004 年之前诊断的乳腺肿瘤中的应用。

Validation of AJCC TNM staging for breast tumors diagnosed before 2004 in cancer registries.

机构信息

Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.

出版信息

Cancer Causes Control. 2012 Sep;23(9):1587-91. doi: 10.1007/s10552-012-0026-7. Epub 2012 Jul 14.

DOI:10.1007/s10552-012-0026-7

PMID:22798182

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3418812/

Abstract

PURPOSE

American Joint Committee on Cancer (AJCC) Tumor (T), Nodal (N), and Metastatic (M) staging is commonly used in clinical practice for treatment decisions, yet before 2004, Surveillance Epidemiology and End Results (SEER)-affiliated cancer registries did not routinely include TNM staging defined by AJCC criteria, reporting instead SEER Summary Staging.

METHODS

We developed and validated an algorithm to determine AJCC TNM staging from Extent of Disease information for 17,133 female breast cancer cases diagnosed from 1988 to 2003 in the cancer registries of Kaiser Permanente Northern and Southern California. Test characteristics (percent agreement, Cohen's kappa, sensitivity, specificity) were calculated to compare derived TNM with gold-standard TNM available in the registry.

RESULTS

Agreement for TNM variables was excellent (range 0.91-1.00 for percent agreement and Cohen's kappa). The sensitivity and specificity, respectively, of the algorithm for AJCC TNM Version 6 staging were as follows: Stage 0 (0.99, 1.00), Stage I (0.97, 0.98), Stage II (0.91, 0.96), Stage III (0.69, 0.99), and Stage IV (0.92, 1.00). Stage III had lower sensitivity due to reclassification of supraclavicular lymph node positivity from M1 (Stage IV) to N3 (Stage IIIC) in AJCC Version 6.

CONCLUSIONS

Derived AJCC staging for breast tumors diagnosed before 2004 is feasible and accurate using cancer registry data.

摘要

目的

美国癌症联合委员会（AJCC）肿瘤（T）、淋巴结（N）和远处转移（M）分期通常用于临床治疗决策，但在 2004 年之前，监测、流行病学和最终结果（SEER）附属癌症登记处并未常规包括 AJCC 标准定义的 TNM 分期，而是报告 SEER 总结分期。

方法

我们开发并验证了一种算法，用于根据 1988 年至 2003 年在 Kaiser Permanente 北加州和南加州癌症登记处诊断的 17133 例女性乳腺癌病例的疾病范围信息确定 AJCC TNM 分期。计算了测试特征（百分比一致性、Cohen's kappa、敏感性、特异性），以比较衍生的 TNM 与登记处中可用的金标准 TNM。

结果

TNM 变量的一致性非常好（百分比一致性和 Cohen's kappa 的范围分别为 0.91-1.00）。该算法用于 AJCC TNM 第 6 版分期的敏感性和特异性分别为：0 期（0.99，1.00）、I 期（0.97，0.98）、II 期（0.91，0.96）、III 期（0.69，0.99）和 IV 期（0.92，1.00）。由于在 AJCC 第 6 版中，锁骨上淋巴结阳性从 M1（IV 期）重新分类为 N3（IIIC 期），因此 III 期的敏感性较低。