Yamasaki S
Dept. of Surgical Oncology, National Cancer Center Hospital, Central Tokyo, Japan.
Gan To Kagaku Ryoho. 1997 Jul;24(9):1175-82.
The current TNM classification of the liver was published in 1987 by UICC, which is the same as the staging system in the general Rules for the Clinical and Pathological Study of Primary Liver Cancer by the Liver Cancer Study Group of Japan (3rd Ed.) and was proposed by the Japanese TNM Committee. This was established based upon the data obtained before 1985. Thus, the current TNM classification does not always meet the latest knowledge of advanced hepatic oncology. The disease in which lesions are present both in the left and the right hepatic lobe is defined as Stage 4. Multiple liver cancers of multicentric carcinogenesis which are present in the two hepatic lobe and which are often detected recently, are stage 4 by the current TNM classification. But the postoperative prognosis of this kind of multiple liver cancer is found to be better than that of stage 4 of the advanced type, and equal to stage 3. Some proposals of reversed TNM classification of the liver, made with a small number of experienced cases have been published. However, not all of them would be convincing even with testing of a large number of cases.
目前的肝脏TNM分类由国际抗癌联盟（UICC）于1987年发布，它与日本肝癌研究组《原发性肝癌临床与病理研究总则》（第3版）中的分期系统相同，由日本TNM委员会提出。这是基于1985年以前获得的数据建立的。因此，目前的TNM分类并不总是符合晚期肝脏肿瘤学的最新知识。左右肝叶均有病变的疾病被定义为IV期。近年来经常检测到的两肝叶多中心发生的多发性肝癌，根据目前的TNM分类属于IV期。但发现这种多发性肝癌的术后预后优于晚期IV期，与III期相当。已经发表了一些对少数经验病例进行的肝脏TNM分类倒置的提议。然而，即使经过大量病例的检验，并非所有提议都能令人信服。
