TNM stage

TNM 阶段
  • 文章类型: Journal Article
    背景:研究表明,AR-V7可能与去势抵抗性前列腺癌(CRPC)的不良预后有关,然而,AR-V7的临床病理特征尚未完全阐明。
    目的:本研究旨在评估CRPC患者AR-V7的临床病理特征。
    方法:评价CRPC患者AR-V7的临床病理特征。搜索PubMed,Embase,WebofScience是用关键词前列腺癌进行的,前列腺肿瘤,前列腺肿瘤,前列腺癌,AR-V7、AR3、雄激素受体剪接变体-7或雄激素受体-3。到2020年2月发表的24项试验包括在这项研究中。
    结果:发现AR-V7阳性CRPC的Gleason评分≥8的比例(69.5%)明显高于阴性(54.9%)(OR1.68,95%CI1.25-2.25,p<0.001),而T3/T4阶段(OR1.16,95%CI0.60-2.24,p=0.65)和N1阶段(OR0.99,95%CI0.65-1.51,p=0.96)的比率与AR-V7状态无统计学相关性。AR-V7阳性患者的任何部位转移(61.3%对35.0%;OR2.19,95%CI1.57-3.05,p<0.001)和骨转移(81.7%对69.0%;OR1.97,95%CI1.44-2.69,p<0.001),预计内脏转移的趋势接近显著性(28.8%对22.1%;OR1.29,95%CI0.96-1.74,p=0.09)。AR-V7阳性CRPC的疼痛发生率(54.6%)明显高于阴性CRPC(28.1%;OR4.23,95%CI2.52-7.10,p<0.001),ECOG表现状况较差(56.7%对35.0%,OR2.18,95%CI1.51-3.16,P<0.001)。研究的局限性包括样本量和设计的差异,AR-V7检测分析,以及纳入研究的疾病特征。
    结论:AR-V7阳性与较高的格里森评分相关,骨或任何部位转移,CRPC中的疼痛和ECOG表现评分较差。然而,与肿瘤分期或淋巴结转移无关。需要更多的研究来证实这些发现。
    BACKGROUND:  Studies have shown that AR-V7 may be correlated with the poor prognosis of castration resistant prostate cancer (CRPC), however, clinicopathological characteristics of AR-V7 have not been fully elucidated.
    OBJECTIVE: This study aimed at evaluating the clinicopathological features of AR-V7 in CRPC patients.
    METHODS: To evaluate the clinicopathological features of AR-V7 in CRPC patients. A search of PubMed, Embase, and Web of Science was performed using the keywords prostate cancer, prostate tumor, prostate neoplasm, prostate carcinoma, AR-V7, AR3, androgen receptor splicing variant-7, or androgen receptor-3. Twenty-four trials published by February 2020 were included in this study.
    RESULTS: The proportion of Gleason score ≥ 8 was found to be significantly higher in AR-V7-positive CRPC (69.5%) than negative (54.9%) (OR 1.68, 95% CI 1.25-2.25, p < 0.001), while the rates of T3/T4 stage (OR 1.16, 95% CI 0.60-2.24, p = 0.65) and N1 stage (OR 0.99, 95% CI 0.65-1.51, p = 0.96) were not statistically correlated with AR-V7 status. The AR-V7-positive patients exhibited a significantly higher proportion of any site metastasis (61.3% versus 35.0%; OR 2.19, 95% CI 1.57-3.05, p < 0.001) and bone metastasis (81.7% versus 69.0%; OR 1.97, 95% CI 1.44-2.69, p < 0.001), and a trend close to significance was expected in visceral metastasis (28.8% versus 22.1%; OR 1.29, 95% CI 0.96-1.74, p = 0.09). Incidences of pain in AR-V7-positive CRPC (54.6%) were significantly higher than in negative CRPC (28.1%; OR 4.23, 95% CI 2.52-7.10, p < 0.001), line with worse ECOG performance status (56.7% versus 35.0%, OR 2.18, 95% CI 1.51-3.16, P < 0.001). Limitations of the study include differences in sample sizes and designs, AR-V7 detection assays, as well as disease characteristics of the included studies.
    CONCLUSIONS: AR-V7 positivity is associated with a higher Gleason score, bone or any site metastasis, pain and worse ECOG performance scores in CRPC. However, it is not correlated with tumor stage or lymph node metastasis. More studies are needed to confirm these findings.
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  • 文章类型: Journal Article
    The eighth edition of the American Joint Committee on Cancer (AJCC8) staging manual has major changes in oral squamous cell carcinoma (OSCC). We searched PubMed, OvidMedline, Scopus, and Web of Science for studies that examined the performance of AJCC8 in OSCC. A total of 40 808 patients were included in the studies of our meta-analysis. A hazard ratio (HR) of 1.87 (95%CI 1.78-1.96) was seen for stage II, 2.65 (95%CI 2.51-2.80) for stage III, 3.46 (95%CI 3.31-3.61) for stage IVa, and 7.09 (95%CI 4.85-10.36) for stage IVb. A similar gradual increase in risk was noted for the N classification. For the T classification, however, there was a less clear variation in risk between T3 and T4. AJCC8 provides a good risk stratification for OSCC. Future research should examine the proposals introduced in the published studies to further improve the performance of AJCC8.
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  • 文章类型: Journal Article
    BACKGROUND: Version 2 of the Collaborative Stage Data Collection System (CSv2) became effective with cases diagnosed in 2010. This report focuses on the CSv2 components required to derive the American Joint Committee on Cancer (AJCC) stage for prostate cancer and on the site-specific factors for prostate cancer captured in CSv2. The report also highlights differences between the AJCC 6th and 7th editions for classifying prostate cancer stage.
    METHODS: Data from 18 Surveillance, Epidemiology, and End Results (SEER) Program population-based registries (SEER-18) were analyzed for the years 2004-2010, which included 400,591 prostate cancer cases.
    RESULTS: CSv2 provides specificity with regard to the Gleason grading system by distinguishing between clinical and pathologic patterns and scores. The AJCC 7th edition incorporates prostate-specific antigen values into staging, subdivides stage II into IIA and IIB, and reclassifies extraprostatic invasion with microscopic bladder neck invasion from T4 in the 6th edition to T3a; this latter change affected the AJCC stage of 283 cases in 2010. Of the 44,578 prostate cancer cases diagnosed in 2010 that would have been classified as stage II in the AJCC 6th edition, 32.7%, 27.5%, and 39.8% are classified as stages I, IIA, and IIB, respectively, in the 7th edition.
    CONCLUSIONS: CSv2 provides more information than was previously available to researchers using SEER prostate data. The absence of a clearly defined clinical stage for each prostate case is the overriding limitation that researchers face in relying on Collaborative Stage information to analyze prostate cancer data.
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