[医学]Lung Cancer Staging Essentials-The New TNM Staging System and Potential Imaging Pitfalls.docVIP

Lung Cancer Staging Essentials: The New TNM Staging System and Potential Imaging Pitfalls（陷阱；易犯的错误） Stacy J. UyBico, MD ? Carol C. Wu, MD ? Robert D. Suh, MD ? Nanette H. Le, DO ? Kathleen Brown, MD ? Mayil S. Krishnam, MD, MRCP, FRCR Abstract Lung cancer is the leading cause of cancer-related deaths worldwide, with a dismal（令人沮丧的；惨淡的，凄凉的） 5-year survival rate of 15%. TheTNM (tumor-node-metastasis) classification system for lung cancer is a vital guide for determining treatment and prognosis（预后）. Despite the importance of accuracy in lung cancer staging, however, correct staging remains a challenging task for many radiologists. The new 7th edition of the TNM classification system features a number of revisions（修订）, including subdivision of tumor categories on the basis of size, differentiation between local intrathoracic and distant metastatic disease, recategorization of malignant pleural or pericardial disease from stage III to stage IV, reclassification of separate tumor nodules in the same lung and lobe as the primary tumor from T4 to T3, and reclassification of separate tumor nodules in the same lung but not the same lobe as the primary tumor from M1 to T4. Radiologists must understand the details set forth （提出；阐明）in the TNM classification system and be familiar with the changes in the 7th edition, which attempts to better correlate disease with prognostic （预后价值）value and treatment strategy. By recognizing the relevant radiologic appearances of lung cancer, understanding the appropriateness of staging disease with the TNM classification system, and being familiar with potential imaging pitfalls, radiologists can make a significant contribution to treatment and outcome in patients with lung cancer. Introduction Lung cancer is the leading cause of cancer-related deaths in the United States, with a 5-year survival rate of only 15%(1). Lung cancer is classified as either non–small cell or small cell lung cancer, with the former accounting for 87% of all lung canc