甲状腺癌术后分期怎么样看
<h2 style="color: black; text-align: left; margin-bottom: 10px;">出院诊断证明书</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">手术做完后,都会拿到出院诊断证明书。诊断证明上会简单的写明你的<span style="color: black;">疾患</span>诊断,我的诊断是:甲状腺乳头状癌左颈转移。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">我记得我当时看诊断的时候还有点懵,<span style="color: black;">由于</span>我没想到<span style="color: black;">已然</span>转移了。懵是<span style="color: black;">由于</span><span style="color: black;">晓得</span>自己<span style="color: black;">生病</span>之后很慌张,很恐惧,对这个病<span style="color: black;">认识</span>的并不多,手术之前<span style="color: black;">亦</span><span style="color: black;">无</span>对颈部淋巴清扫跟<span style="color: black;">医生</span>沟通。<span style="color: black;">不外</span><span style="color: black;">亦</span>没<span style="color: black;">那样</span>意外,虽然术前的彩超<span style="color: black;">无</span>报淋巴肿大,但<span style="color: black;">加强</span>CT还是写了,有<span style="color: black;">反常</span>淋巴结。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">不外</span>很<span style="color: black;">幸运</span>,在我和家人都懵懵的时候来到了东肿,把自己交给了专业的医院和专业的<span style="color: black;">大夫</span>。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">病理报告</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">两个星期的等待,病理报告出来了,病理分期为“pTNM:pT3bN1b”。找<span style="color: black;">医生</span>问这个分级<span style="color: black;">表率</span>什么还要等一段时间,我<span style="color: black;">起始</span><span style="color: black;">各样</span>查资料,想弄清楚到底是什么意思。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-b07cf2a78a3b37b4ed8c5893776a8063_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">分期<span style="color: black;">怎样</span>看</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">找了<span style="color: black;">非常多</span><span style="color: black;">文案</span>和材料,<span style="color: black;">最终</span>找到了甲状腺癌诊疗规范(AJCC第8版):</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">P<span style="color: black;">表率</span>病理类型及血管<span style="color: black;">可否</span>侵犯,T<span style="color: black;">表率</span>原发肿瘤,N<span style="color: black;">表率</span>淋巴结,M<span style="color: black;">表率</span>远处转移。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">针对甲状腺癌的分期<span style="color: black;">按照</span>手术前<span style="color: black;">评定</span>(病史、查体、辅助<span style="color: black;">检测</span>)确立的临床分期和<span style="color: black;">按照</span>术后病理的病理分期,<span style="color: black;">详细</span>分期标准如下。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1、</span>看肿瘤</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1、如下标准适用于甲状腺乳头状癌、滤泡癌、低分化癌、Hürthle细胞癌和未分化癌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pTX:原发肿瘤<span style="color: black;">不可</span><span style="color: black;">评定</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT0:<span style="color: black;">没</span>肿瘤证据</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT1:肿瘤局限在甲状腺内,最大径≤2cm</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">T1a 肿瘤最大径≤1cm</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">T1b肿瘤最大径>1cm,≤2cm</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT2:肿瘤2~4cm</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT3:肿瘤>4cm,局限于甲状腺内或大体侵犯甲状腺外带状肌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT3a:肿瘤>4cm,局限于甲状腺内</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT3b:大体侵犯甲状腺外带状肌,<span style="color: black;">没</span>论肿瘤<span style="color: black;">体积</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">带状肌<span style="color: black;">包含</span>:胸骨舌骨肌、胸骨甲状肌、甲状舌骨肌、肩胛舌骨肌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT4:大体侵犯甲状腺外带状肌外</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT4a:侵犯喉、气管、食管、喉反神经及皮下软组织</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT4b:侵犯椎前筋膜,或包裹颈动脉、纵隔血管</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2、如下标准适用于甲状腺髓样癌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pTX:原发肿瘤<span style="color: black;">不可</span><span style="color: black;">评定</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT0:<span style="color: black;">没</span>肿瘤证据</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT1:肿瘤局限在甲状腺内,最大径≤2cm</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">T1a 肿瘤最大径≤1cm</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">T1b肿瘤最大径>1cm,≤2cm</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT2:肿瘤2~4cm</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT3:肿瘤>4cm,局限于甲状腺内或大体侵犯甲状腺外带状肌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT3a:肿瘤>4cm,局限于甲状腺内</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT3b:大体侵犯甲状腺外带状肌,<span style="color: black;">没</span>论肿瘤大小</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">带状肌<span style="color: black;">包含</span>:胸骨舌骨肌、胸骨甲状肌、甲状舌骨肌、肩胛舌骨肌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT4:<span style="color: black;">发展</span>期病变</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT4a:中度<span style="color: black;">发展</span>,任何<span style="color: black;">体积</span>的肿瘤,侵犯甲状腺外颈部<span style="color: black;">周边</span>器官和软组织,如喉、气管、食管、喉反神经及皮下软组织</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pT4b:重度<span style="color: black;">发展</span>,任何<span style="color: black;">体积</span>的肿瘤,侵犯椎前筋膜,或包裹颈动脉、纵隔血管</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2、</span>看区域淋巴结:如下标准适用于所有甲状腺癌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pN0:<span style="color: black;">没</span>淋巴结转移证据</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pN1:区域淋巴结转移</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pN1a:转移至Ⅵ、Ⅶ区(<span style="color: black;">包含</span>气管旁、气管前、喉前/Delphian或上纵隔)淋巴结,<span style="color: black;">能够</span>为单侧或双侧。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">pN1b:单侧、双侧或对侧颈淋巴结转移(<span style="color: black;">包含</span>Ⅰ、Ⅱ、Ⅲ、Ⅳ或Ⅴ区)淋巴结或咽后淋巴结转移。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">看懂这个以后,<span style="color: black;">大众</span>就<span style="color: black;">能够</span><span style="color: black;">根据</span>下表给自己分期</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">TNM分期系统是<span style="color: black;">日前</span>国际上最为通用的肿瘤分期系统。<span style="color: black;">首要</span>由法国人Pierre Denoix于1943年至1952年间提出,后来美国癌症联合委员会(AJCC,American Joint Committee on Cancer)和国际抗癌联盟(UICC,Union for International Cancer Control)逐步<span style="color: black;">起始</span><span style="color: black;">创立</span>国际性的分期标准,并于1968年正式出版了第1版《恶性肿瘤 INM<span style="color: black;">归类</span>法》手册。<span style="color: black;">日前</span>他<span style="color: black;">已然</span><span style="color: black;">作为</span>临床<span style="color: black;">大夫</span>和医学科学工作者对恶性肿瘤进行分期的标准<span style="color: black;">办法</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">TNM分期中T,N,M确定后就<span style="color: black;">能够</span>得出相应的</p>
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