medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-2017-6-41-48medvis-488Research ArticleБРЮШНАЯ ПОЛОСТЬABDOMENВосьмое издание Международной TNM-классификации злокачественных опухолей печениEighth Edition of the International TNM Classification of Malignant Tumors of the LiverЩеголевА. И.ShchegolevA. I.

Щеголев Александр Иванович – доктор медицинских наук, профессор, заведующий патологоанатомическим отделением.

117997 Москва, ул. Академика Опарина, д. 4, тел.: 8-495-531-44-44

Aleksandr I. Shchegolev – doct. of med. sci., professor, Head of Department of Morbid Anatomy.

Academika Oparina str., 4, Moscow, 117997, Phone: 8-495-531-44-44

ashegolev@oparina4.ruТумановаУ. Н.TumanovaU. N.

Туманова Ульяна Николаевна –  кандидат медицинских наук, научный сотрудник патологоанатомического отделения.

Москва

Ulyana N. Tumanova – scientific researcher, Department of Morbid Anatomy of Research Center.

КармазановскийГ. Г.KarmazanovskyG. G.

Кармазановский Григорий Григорьевич – член-корр. РАН, доктор медицинских наук, профессор, руководитель отдела лучевой диагностики.

Grigory G. Karmazanovsky – corresponding member of RAS, doct. of med. sci., professor, Head of the Radiology Department.

ФГБУ “Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова” Минздрава РоссииРоссияAcademician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and PerinatologyRussian FederationФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава РоссииРоссияA.V. Vishnevsky Institute of surgeryRussian Federation201728122017064148Copyright © Щеголев А.И., Туманова У.Н., Кармазановский Г.Г., 20172017Щеголев А.И., Туманова У.Н., Кармазановский Г.Г.Shchegolev A.I., Tumanova U.N., Karmazanovsky G.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/488

Приведены новые критерии T, N и M категории и характеристики стадий гепатоцеллюлярной карциномы и внутрипеченочной холангиокарциномы, представленные в восьмом издании Международной TNM-классификации злокачественных опухолей 2017 г. Указаны отличия данной классификации от предыдущего седьмого издания 2009 г., обусловленные получением новых данных о выживаемости больных. Основными характеристиками первичной опухоли остались ее размеры, количество узлов и наличие сосудистой инвазии.

New criteria for T, N and M categories and characteristics of the stages of hepatocellular carcinoma and intrahepatic cholangiocarcinoma are presented in the eighth edition of the international TNM classification of malignant tumors in 2017. The differences of this classification from the previous seventh edition of 2009 are noted, due to the receipt of new data on the survival of patients. The main characteristics of the primary tumor remained its size, the number of nodes and the presence of vascular invasion.

TNM-классификацияпеченьгепатоцеллюлярная карциномавнутрипеченочная холангиокарциномаTNM classificationliverhepatocellular carcinomaintrahepatic cholangiocarcinomaReferencesDenoix P.F. Nomenclature des cancer. Bull. Inst. Nat. Hyg. (Paris). 1944: 69–73.Denoix P.F. Nomenclature des cancer. Bull. Inst. Nat. Hyg. (Paris). 1944: 69–73.International Union Against Cancer (UICC) Committee on Clinical Stage Classification and Applied Statistics. Clinical Stage Classification and Presentation of Results, Malignant Tumours of the Breast and Larynx. Paris, 1958.International Union Against Cancer (UICC) Committee on Clinical Stage Classification and Applied Statistics. Clinical Stage Classification and Presentation of Results, Malignant Tumours of the Breast and Larynx. Paris, 1958.TNM classification of malignant tumours. Eds J.D. Brierley, M.K. Gospodarowicz, Ch. Wittekind. 8th ed New York: Wiley-Blackwell, 2017. 272 p.TNM classification of malignant tumours. Eds J.D. Brierley, M.K. Gospodarowicz, Ch. Wittekind. 8th ed New York: Wiley-Blackwell, 2017. 272 p.AJCC cancer staging manual, Eighth ed. Ed. Chief M.B. Amin. Springer, 2017. 1024 p.AJCC cancer staging manual, Eighth ed. Ed. Chief M.B. Amin. Springer, 2017. 1024 p.TNM Classification of malignant tumours. 7th ed. Eds L.H. Sobin, M.K. Gospodarowicz, Ch. Wittekind. New York: Wiley-Blackwell, 2009. 310 p.TNM Classification of malignant tumours. 7th ed. Eds L.H. Sobin, M.K. Gospodarowicz, Ch. Wittekind. New York: Wiley-Blackwell, 2009. 310 p.Bosman F.T., Carneiro F., Hruban R.H., Theise N.D. eds. World Health Organization Classification of Tumours of the Digestive System. Lyon: IARC. 2010. 417 p.Bosman F.T., Carneiro F., Hruban R.H., Theise N.D. eds. World Health Organization Classification of Tumours of the Digestive System. Lyon: IARC. 2010. 417 p.Щеголев А.И., Мишнев О.Д. Онкоморфология печени. М.: Изд-во РГМУ, 2006. 252 с.Shchegolev A. I., Mishnev O. D. Oncomorphology liver. M.: Publishing RSSU, 2006; 252 p. (In Russian)Torbenson M. Fibrolamellar carcinoma: 2012 update. Scientifica (Cairo). 2012; 2012: 743790. DOI: 10.6064/2012/743790.Torbenson M. Fibrolamellar carcinoma: 2012 update. Scientifica (Cairo). 2012; 2012: 743790. DOI: 10.6064/2012/743790.Mayo S.C., Mavros M.N., Nathan H., Cosgrove D., Herman J.M., Kamel I., Anders R.A., Pawlik T.M. Treatment and prognosis of patients with fibrolamellar hepatocellular carcinoma: a national perspective. J. Am. Coll. Surg. 2014; 218: 196–205. DOI: 10.1016/j.jamcollsurg.2013.10.011.Mayo S.C., Mavros M.N., Nathan H., Cosgrove D., Herman J.M., Kamel I., Anders R.A., Pawlik T.M. Treatment and prognosis of patients with fibrolamellar hepatocellular carcinoma: a national perspective. J. Am. Coll. Surg. 2014; 218: 196–205. DOI: 10.1016/j.jamcollsurg.2013.10.011.Jernigan P.L., Wima K., Hanseman D.J., Hoehn R.S., Ahmad S.A., Shah S.A., Abbott D.E. Natural history and treatment trends in hepatocellular carcinoma subtypes: Insights from a national cancer registry. J. Surg. Oncol. 2015; 112: 872–876. DOI: 10.1002/jso.24083.Jernigan P.L., Wima K., Hanseman D.J., Hoehn R.S., Ahmad S.A., Shah S.A., Abbott D.E. Natural history and treatment trends in hepatocellular carcinoma subtypes: Insights from a national cancer registry. J. Surg. Oncol. 2015; 112: 872–876. DOI: 10.1002/jso.24083.Edmondson H.A., Steiner P.E. Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies. Cancer. 1954; 7: 462–504.Edmondson H.A., Steiner P.E. Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies. Cancer. 1954; 7: 462–504.Kudo M., Chung H., Haji S., Osaki Y., Oka H., Seki T., Kasugai H., Sasaki Y., Matsunaga T. Validation of a new prognostic staging system for hepato-cellular carcinoma: the JIS score compared with the CLIP score. Hepatology. 2004; 40: 1396–1405. DOI: 10.1002/hep.20486.Kudo M., Chung H., Haji S., Osaki Y., Oka H., Seki T., Kasugai H., Sasaki Y., Matsunaga T. Validation of a new prognostic staging system for hepato-cellular carcinoma: the JIS score compared with the CLIP score. Hepatology. 2004; 40: 1396–1405. DOI: 10.1002/hep.20486.Toyoda H., Kumada T., Kiriyama S., Sone Y., Tanikawa M., Hisanaga Y., Yamaguchi A., Isogai M., Kaneoka Y., Washizu J. Comparison of the usefulness of three staging systems for hepatocellular carcinoma (CLIP, BCLC, and JIS) in Japan. Am. J. Gastroenterol. 2005; 100: 1764–1771. DOI: 10.1111/j.1572-0241.2005.41943.x.Toyoda H., Kumada T., Kiriyama S., Sone Y., Tanikawa M., Hisanaga Y., Yamaguchi A., Isogai M., Kaneoka Y., Washizu J. Comparison of the usefulness of three staging systems for hepatocellular carcinoma (CLIP, BCLC, and JIS) in Japan. Am. J. Gastroenterol. 2005; 100: 1764–1771. DOI: 10.1111/j.1572-0241.2005.41943.x.Туманова У.Н., Щеголев А.И. Системы стадирования гепатоцеллюлярного рака. Экспериментальная и клиническая гастроэнтерология. 2016; 7: 121–128.Tumanova U.N., Shchegolev A.I. Staging systems of hepatocellular carcinoma. Eksperimental'naya i klinicheskaya gastrojenterologiya. 2016; 7: 121–128. (In Russian)Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. The French METAVIR Cooperative Study Group. Hepatology. 1994: 20: 15–20.Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. The French METAVIR Cooperative Study Group. Hepatology. 1994: 20: 15–20.Batts K.P., Ludwig J. Chronic hepatitis. An update on terminology and reporting. Am. J. Surg. Pathol. 1995; 19: 1409–1417.Batts K.P., Ludwig J. Chronic hepatitis. An update on terminology and reporting. Am. J. Surg. Pathol. 1995; 19: 1409–1417.Ishak K., Baptista A., Bianchi L., Callea F., De Groote J., Gudat F., Denk H., Desmet V., Korb G., MacSween R.N. Histological grading and staging of chronic hepatitis. J. Hepatol. 1995; 22: 696–699.Ishak K., Baptista A., Bianchi L., Callea F., De Groote J., Gudat F., Denk H., Desmet V., Korb G., MacSween R.N. Histological grading and staging of chronic hepatitis. J. Hepatol. 1995; 22: 696–699.Vauthey J.N., Lauwers G.Y., Esnaola N.F., Do K.A., Belghiti J., Mirza N., Curley S.A., Ellis L.M., Regimbeau J.M., Rashid A., Cleary K.R., Nagorney D.M. Simplified staging for hepatocellular carcinoma. J. Clin. Oncol. 2002; 20: 1527–1536. DOI: 10.1200/JCO.2002.20.6.1527.Vauthey J.N., Lauwers G.Y., Esnaola N.F., Do K.A., Belghiti J., Mirza N., Curley S.A., Ellis L.M., Regimbeau J.M., Rashid A., Cleary K.R., Nagorney D.M. Simplified staging for hepatocellular carcinoma. J. Clin. Oncol. 2002; 20: 1527–1536. DOI: 10.1200/JCO.2002.20.6.1527.Shindoh J., Andreou A., Aloia T.A., Zimmitti G., Lauwers G.Y., Laurent A., Nagorney D.M., Belghiti J., Cherqui D., Poon R.T., Kokudo N., Vauthey J.N. Microvascular invasion does not pre-dict long-term survival in hepatocellular carcinoma up to 2 cm: reappraisal of the staging system for solitary tumors. Ann. Surg. Oncol. 2013; 20: 1223–1229. DOI: 10.1245/s10434-012-2739-y.Shindoh J., Andreou A., Aloia T.A., Zimmitti G., Lauwers G.Y., Laurent A., Nagorney D.M., Belghiti J., Cherqui D., Poon R.T., Kokudo N., Vauthey J.N. Microvascular invasion does not pre-dict long-term survival in hepatocellular carcinoma up to 2 cm: reappraisal of the staging system for solitary tumors. Ann. Surg. Oncol. 2013; 20: 1223–1229. DOI: 10.1245/s10434-012-2739-y.Chan A.C., Fan S.T., Poon R.T., Cheung T.T., Chok K.S., Chan S.C., Lo C.M. Evaluation of the seventh edition of the American Joint Committee on Cancer tumour-nodemetastasis (TNM) staging system for patients undergoing curative resection of hepatocellular carcinoma: implications for the development of a refined staging system. HPB (Oxford). 2013; 15: 439–448. DOI: 10.1111/j.1477-2574.2012.00617.x.Chan A.C., Fan S.T., Poon R.T., Cheung T.T., Chok K.S., Chan S.C., Lo C.M. Evaluation of the seventh edition of the American Joint Committee on Cancer tumour-nodemetastasis (TNM) staging system for patients undergoing curative resection of hepatocellular carcinoma: implications for the development of a refined staging system. HPB (Oxford). 2013; 15: 439–448. DOI: 10.1111/j.1477-2574.2012.00617.x.An C., Choi G.H., Lee H.S., Kim M.J. Assessment of preoperative magnetic resonance imaging staging in patients with hepatocellular carcinoma undergoing resection compared with the seventh American Joint Committee on Cancer System. Invest. Radiol. 2012; 47: 634–641. DOI: 10.1097/RLI.0b013e3182630e8d.An C., Choi G.H., Lee H.S., Kim M.J. Assessment of preoperative magnetic resonance imaging staging in patients with hepatocellular carcinoma undergoing resection compared with the seventh American Joint Committee on Cancer System. Invest. Radiol. 2012; 47: 634–641. DOI: 10.1097/RLI.0b013e3182630e8d.Shah S., Shukla A., Paunipagar B. Radiological features of hepatocellular carcinoma. J. Clin. Exp. Hepatol. 2014; 4: 63–66. DOI: 10.1016/j.jceh.2014.06.009.Shah S., Shukla A., Paunipagar B. Radiological features of hepatocellular carcinoma. J. Clin. Exp. Hepatol. 2014; 4: 63–66. DOI: 10.1016/j.jceh.2014.06.009.Туманова У.Н., Кармазановский Г.Г., Щеголев А.И. Система LI-RADS при компьютерно-томографической диагностике гепатоцеллюлярного рака. Медицинская визуализация. 2014; 6: 44–50.Tumanova U.N., Karmazanovsky G.G., Shchegolev A.I. LIRADS system for computer-tomographic diagnosis of hepatocellular carcinoma. Medical Visualization. 2014; 6: 44–50. (In Russian)Krinsky G. Imaging of dysplastic nodules and small hepatocellular carcinomas: experience with explanted livers. Intervirology. 2004; 47: 191–198. DOI: 10.1159/000078472.Krinsky G. Imaging of dysplastic nodules and small hepatocellular carcinomas: experience with explanted livers. Intervirology. 2004; 47: 191–198. DOI: 10.1159/000078472.Lee J.M., Choi B.I. Hepatocellular nodules in liver cirrhosis: MR evaluation. Abdom. Imaging. 2011; 36: 282–289. DOI: 10.1007/s00261-011-9692-2.Lee J.M., Choi B.I. Hepatocellular nodules in liver cirrhosis: MR evaluation. Abdom. Imaging. 2011; 36: 282–289. DOI: 10.1007/s00261-011-9692-2.Туманова У.Н., Кармазановский Г.Г., Щеголев А.И. Предопухолевые узелковые образования печени: мор фо логические и магнитно-резонансно-томографические сопоставления. Медицинская визуализация. 2016; 6: 41–51.Tumanova U.N., Karmazanovsky G.G., Shchegolev A.I. Preneoplastic nodular lesions of the liver: morphological and magnetic resonance tomography comparison. Medical Visualization. 2016; 6: 41–51. (In Russian)Туманова У.Н., Кармазановский Г.Г., Щёголев А.И. Денситометрические характеристики гепатоцеллюлярного рака при спиральной компьютерной томографии. Медицинская визуализация. 2012; 6: 42–49.Tumanova U.N., Karmazanovsky G.G., Shchegolev A.I. Densitometric characteristics of hepatocellular carcinoma at spiral computed tomography. Medical Visualization. 2012; 6: 42–49. (In Russian)Туманова У.Н., Кармазановский Г.Г., Щёголев А.И. Компьютерно-томографические характеристики степени васкуляризации гепатоцеллюлярного рака. Меди цинская визуализация. 2013; 1: 52–58.Tumanova U.N., Karmazanovsky G.G., Shchegolev A.I. Characterize the degree of vascularization of hepatocellular carcinoma at spiral computed tomography. Medical Visualization. 2013; 1: 52–58. (In Russian)Трефилов А.А., Карельская Н.А., Кармазановский Г.Г., Степанова Ю.А. Лучевая диагностика гепатоцеллюлярного рака на фоне цирроза печени. Диагностическая и интервенционная радиология. 2014; 2-2: 70–80.Trefylov A.A., Karelskaya N.A., Karmazanovsky G.G., Stepanova Yu.A. Radiological diagnosis of hepatocellular carcinoma in patients with liver cirrhosis. Diagnosticheskaya i interventsionnaya radiologiya. 2014; 2-2: 70–80. (In Russian)Андреева Р.М., Самсонов В.А., Федорова Л.А., Некачалов В.В. Клинико-морфологическая характеристика рака печени. Вопросы онкологии. 1966; 3: 91–92.Andreeva R.M., Samsonov V.A., Fedorova L.A., Nekachalov V.V. Clinical and morphological characteristics of liver cancer. Voprosy onkologii. 1966; 3: 91–92. (In Russian)Ringe K.I., Wacker F. Radiological diagnosis in cholangiocarcinoma: Application of computed tomo graphy, magnetic resonance imaging, and positron emission tomography. Best Pract. Res. Clin. Gastroenterol. 2015; 29: 253–265. DOI: 10.1016/j.bpg.2015.02.004Ringe K.I., Wacker F. Radiological diagnosis in cholangiocarcinoma: Application of computed tomo graphy, magnetic resonance imaging, and positron emission tomography. Best Pract. Res. Clin. Gastroenterol. 2015; 29: 253–265. DOI: 10.1016/j.bpg.2015.02.004Arrivé L., Hodoul M., Arbache A., Slavikova-Boucher L., Menu Y., El Mouhadi S. Magnetic resonance cholangiography: Current and future perspectives. Clin. Res. Hepatol. Gastroenterol. 2015; 39: 659–664. DOI: 10.1016/j.clinre.2015.07.005.Arrivé L., Hodoul M., Arbache A., Slavikova-Boucher L., Menu Y., El Mouhadi S. Magnetic resonance cholangiography: Current and future perspectives. Clin. Res. Hepatol. Gastroenterol. 2015; 39: 659–664. DOI: 10.1016/j.clinre.2015.07.005.Jang H.J., Yu H., Kim T.K. Contrast-enhanced ultrasound in the detection and characterization of liver tumors. Cancer Imaging. 2009; 9: 96–103. DOI: 10.1102/1470-7330.2009.0015.Jang H.J., Yu H., Kim T.K. Contrast-enhanced ultrasound in the detection and characterization of liver tumors. Cancer Imaging. 2009; 9: 96–103. DOI: 10.1102/1470-7330.2009.0015.Lazaridis K.N., Gores G.J. Primary sclerosing cholangitis and cholangiocarcinoma. Semin. Liver Dis. 2006; 26: 42–51. DOI: 10.1055/s-2006-933562.Lazaridis K.N., Gores G.J. Primary sclerosing cholangitis and cholangiocarcinoma. Semin. Liver Dis. 2006; 26: 42–51. DOI: 10.1055/s-2006-933562.

The authors declare that there are no conflicts of interest present.