关于癌症：什么是肿瘤的TNM分期？
<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</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">首要</span>由一位法国人与1943年到1952年间提出，后来美国癌症联合委员会和国际抗癌联盟逐步<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<span style="color: black;">第1</span>版恶性肿瘤TNM<span style="color: black;">归类</span>法手册。<span style="color: black;">日前</span>它<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<span style="color: black;">针对</span>恶性肿瘤进行分期的标准<span style="color: black;">办法</span>，<span style="color: black;">已然</span>更新到第八版。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">每一种肿瘤的TNM分期系统各不相同，<span style="color: black;">因此呢</span>TNM分期中字母和数字的含义在不同肿瘤所<span style="color: black;">表率</span>的意思不同。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span>在胃癌中，T就<span style="color: black;">表率</span>肿瘤的侵犯<span style="color: black;">周边</span>组织的程度，<span style="color: black;">倘若</span>肿瘤还局限在粘膜或粘膜下层，<span style="color: black;">便是</span>T1<span style="color: black;">周期</span>。<span style="color: black;">倘若</span>肿瘤进一步向胃壁生长侵犯了肌肉层，<span style="color: black;">便是</span>T2<span style="color: black;">周期</span>，<span style="color: black;">倘若</span>肿瘤<span style="color: black;">已然</span>长到了胃壁<span style="color: black;">乃至</span>穿出了胃壁，<span style="color: black;">便是</span>T3和T4.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">N<span style="color: black;">表率</span>了淋巴结的转移。<span style="color: black;">按照</span>术前的影像学分期<span style="color: black;">或</span>手术切除下来的组织标本进行病理<span style="color: black;">检测</span>，<span style="color: black;">倘若</span><span style="color: black;">发掘</span>淋巴结内有癌转移，就<span style="color: black;">按照</span><span style="color: black;">已然</span>有转移的淋巴结个数和多少，进行N1到N3的<span style="color: black;">归类</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">M<span style="color: black;">表率</span>远处转移，<span style="color: black;">例如</span>转移到肝脏，肺部<span style="color: black;">或</span>腹膜等有转移，<span style="color: black;">便是</span>M1, <span style="color: black;">无</span>转移，<span style="color: black;">便是</span>M0。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">这般</span>再<span style="color: black;">按照</span>不同的TNM组合就<span style="color: black;">能够</span>得出相应的总分期，即一期，二期，三期，四期等。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic3.zhimg.com/80/v2-f7e65991ce51073de7f76e7bc004f7ca_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但<span style="color: black;">必须</span><span style="color: black;">重视</span>不同的肿瘤有不同的TNM界定<span style="color: black;">办法</span>，<span style="color: black;">例如</span>乳腺癌<span style="color: black;">或</span>甲状腺癌的T分期<span style="color: black;">便是</span><span style="color: black;">按照</span>肿瘤<span style="color: black;">体积</span>来决定的。<span style="color: black;">另一</span>，TNM<span style="color: black;">亦</span>分为手术前的临床分期和手术以后的术后病理分期。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">TNM分期有什么<span style="color: black;">功效</span>？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">首要</span>这是一种国际通用的医学语言，<span style="color: black;">经过</span>统一的分期<span style="color: black;">归类</span>，<span style="color: black;">大夫</span>之间<span style="color: black;">针对</span><span style="color: black;">疾患</span>的诊断和治疗就会在一个统一分期的<span style="color: black;">基本</span>上，让交流和对比变得更为统一和规范。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">其次，不同的TNM分期得出的分析结论直接就对应着后期的治疗<span style="color: black;">方法</span>的<span style="color: black;">选取</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span>还是以胃癌为例，<span style="color: black;">倘若</span>是I期胃癌，肿瘤仅仅局限于粘膜层内，就<span style="color: black;">能够</span><span style="color: black;">经过</span>内镜下完成治疗，<span style="color: black;">倘若</span>是II期到III期就要<span style="color: black;">思虑</span>手术，或是在手术前先完成新辅助治疗。手术以后再<span style="color: black;">按照</span>术后病理的TNM分期决定后续<span style="color: black;">是不是</span><span style="color: black;">必须</span>完成进一步的放疗和化疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span><span style="color: black;">已然</span>是胃癌IV期，<span style="color: black;">亦</span><span style="color: black;">便是</span>治疗前<span style="color: black;">已然</span><span style="color: black;">显现</span>了远处转移，这个时候就要以化疗、放疗、靶向治疗等综合全身性治疗为主了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">最后TNM分期还<span style="color: black;">供给</span>了预后信息，<span style="color: black;">便是</span><span style="color: black;">能够</span>预测及以后的治疗<span style="color: black;">方法</span>，<span style="color: black;">病人</span>的肿瘤发展或复发转移的可能性及<span style="color: black;">长时间</span><span style="color: black;">存活</span>的预期，越早分期的肿瘤治疗效果越好，<span style="color: black;">将来</span><span style="color: black;">存活</span>时间越长。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">重疾险新规将恶性肿瘤中的一期甲状腺癌从重疾移到了轻症中。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">详细</span>来看一下什么是甲状腺I期。<span style="color: black;">按照</span>TNM分期，T<span style="color: black;">便是</span>肿瘤的<span style="color: black;">体积</span>和侵及的范围。N是淋巴结转移，M是远处转移。<span style="color: black;">倘若</span>拿甲状腺癌最<span style="color: black;">平常</span>的乳头状癌来看，<span style="color: black;">倘若</span>在55岁以下，I期甲状腺癌<span style="color: black;">便是</span>任何T任何N以及M0。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">便是</span>只要<span style="color: black;">无</span>远处转移的,年轻的,甲状腺乳头癌<span style="color: black;">病人</span>,都是I期甲状腺癌，属于轻度<span style="color: black;">疾患</span>理赔范围。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">然则</span><span style="color: black;">针对</span>年龄大于55岁并有淋巴结转移的<span style="color: black;">病人</span>，或<span style="color: black;">病人</span>的病理类型为”髓样癌”，“未分化癌”都在重症范围内理赔。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">日前</span>临床大部分都是比较<span style="color: black;">青年</span>的甲状腺癌<span style="color: black;">病人</span>，<span style="color: black;">况且</span>大部分都是乳头状或滤泡状癌的病理类型。而随着<span style="color: black;">大众</span>对甲状腺<span style="color: black;">检测</span>的<span style="color: black;">逐步</span><span style="color: black;">注意</span>，临床上大部分甲状腺癌<span style="color: black;">病人</span>都是很<span style="color: black;">初期</span>就<span style="color: black;">发掘</span>并治疗了。真的达到I期以上的甲状腺癌<span style="color: black;">病人</span>是比较少见的。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-49cbbd766dd5e17a0c39b22a53660548_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
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