中山大学肿瘤中心Jun Ma，Ying Sun，Li-Zhi Liu和Ming-Yuan Chen共同合作，近期取得重要工作进展。他们研究完善了EBV相关鼻咽癌第8版TNM分类。相关研究成果2024年1月18日在线发表于《癌细胞》杂志上。

据介绍，AJCC/UIACC TNM分类描述了肿瘤进展的解剖程度，并指导治疗决策。研究人员对来自六个中国团体的8834名新诊断的非转移性EB病毒相关鼻咽癌（NPC）患者的综合分析表明，目前的分期系统存在一定的局限性。AJCC/UICC第8版TNM分类不能充分区分患者的预后，特别是T2和T3分类之间以及N分类内。

研究人员建议将早期颅底侵犯的T3型NPC病例重新分类为T2，并将图像识别为3级结外延伸（ENE）的N1-N2例提升为N3。

此外，研究人员建议将T2N0和T1N0合并为一个单一的IA期。对于新发转移性（M1）NPC，研究人员提出了M1a和M1b的细分，前者定义为1-3个无肝脏累及的转移性病灶，后者定义为>3个转移性病灶或累及肝脏。

总之，这一建议更好地反映了鼻咽癌患者对最新治疗方法的反应及其不断变化的风险概况。

附：英文原文

Title: Refining the 8th edition TNM classification for EBV related nasopharyngeal carcinoma

Author: Xiao-Jing Du, Gao-Yuan Wang, Xiao-Dong Zhu, Ya-Qian Han, Feng Lei, Liang-Fang Shen, Kun-Yu Yang, Lei Chen, Yan-Ping Mao, Ling-Long Tang, Ling Li, Zheng Wu, Gui-Qiong Xu, Qin Zhou, Jing Huang, Rui Guo, Yuan Zhang, Xu Liu, Guan-Qun Zhou, Wen-Fei Li, Cheng Xu, Li Lin, Yu-Pei Chen, Fo-Ping Chen, Xiao-Yu Liang, Si-Yuan Chen, Shu-Qi Li, Chun-Yan Cui, Ji-Bin Li, Jian Ren, Ming-Yuan Chen, Li-Zhi Liu, Ying Sun, Jun Ma

Issue&Volume: 2024-01-18

Abstract: The AJCC/UICC TNM classification describes anatomic extent of tumor progression and guides treatment decisions. Our comprehensive analysis of 8,834 newly diagnosed patients with non-metastatic Epstein-Barr virus related nasopharyngeal carcinoma (NPC) from six Chinese centers indicates certain limitations in the current staging system. The 8th edition of the AJCC/UICC TNM classification inadequately differentiates patient outcomes, particularly between T2 and T3 categories and within the N classification. We propose reclassifying cases of T3 NPC with early skull-base invasion as T2, and elevating N1-N2 cases with grade 3 image-identified extranodal extension (ENE) to N3. Additionally, we suggest combining T2N0 with T1N0 into a single stage IA. For de novo metastatic (M1) NPC, we propose subdivisions of M1a, defined by 1–3 metastatic lesions without liver involvement, and M1b, characterized by >3 metastatic lesions or liver involvement. This proposal better reflects responses of NPC patients to the up-to-date treatments and their evolving risk profiles.

DOI: 10.1016/j.ccell.2023.12.020

Source: https://www.cell.com/cancer-cell/fulltext/S1535-6108(23)00448-8