Ohta H, Takahashi T
Gan No Rinsho. 1986 Aug;32(10):1379-82.
Problems in General Rules (Japan) and TNM Classification (UICC) for, and the prognoses of rectal cancer were considered. The problems of rules are concerned with the division of the rectal locations, depth of the wall invasion, lymph-node classification, vasal infiltration, edge of the resected specimen (EW), etc. And the General Rules and TNM Classification were compared in these respects stage by stage. The locations of rectal cancer (Rb, Ra, Rs,) are asked to be indicated, setting up the borders at 1 cm, 6 cm, 12 cm above DL (dentate line), as Rb (1.1-6.0 above DL), Ra (6.1-12 above DL) and Rs (12.1-15 above DL). With regard to the depth of the wall invasion, the parts lacking in and having the serosa are asked to be contrasted as a1 and ss or a2 and s(+). With regard to ly, v that influences greatly the prognosis, it should be shown either positive or negative, and also the distance from EW be measured. Under TNM Classifications, there are observed some strains in the ratings of the metastasis of lymph-nodes and the depth of invasions, whereas the General Rules are quite peculiar of them. And it is of great rate clinical significance that the stages have been provided depending on the difference of ratings.
探讨了日本《大肠癌诊疗规范》及国际抗癌联盟（UICC）的TNM分类中存在的问题以及直肠癌的预后。规范方面的问题涉及直肠部位的划分、肠壁浸润深度、淋巴结分类、血管浸润、切除标本边缘（EW）等。并在这些方面逐阶段比较了《大肠癌诊疗规范》与TNM分类。要求标明直肠癌的部位（Rb、Ra、Rs），以齿状线（DL）上方1cm、6cm、12cm为界，分别为Rb（DL上方1.1 - 6.0cm）、Ra（DL上方6.1 - 12cm）和Rs（DL上方12.1 - 15cm）。关于肠壁浸润深度，应将有无浆膜的部分分别对比为a1和ss或a2和s(+)。对于对预后影响极大的ly、v，应表明其阳性或阴性，同时测量距EW的距离。在TNM分类中，淋巴结转移分级和浸润深度的评级存在一些差异，而《大肠癌诊疗规范》在这些方面则较为独特。并且根据评级差异划分阶段具有重要的临床意义。
