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DIENDAN Y HOC

Chuyen de trong thang

He thdng xep giai doan

ung thu" phoi mdi

Hoang Hdng Thai*, NguySn Quang Dgi*

T()M TAT

Viec xac dinh giai doan la mgt vdn dS quan trong khi dat chdn doan xac dinh d benh nhan ung thu.

Hiep hoi kidm soat ung thu qudc td(UlCC) va Lien Uy ban ung thu Hoa Ky (AJCC) da dua ra dmh nghla,

xem xet dinh ky, cai tidn nhdng he thdng phan giai doan. He thdng phan loai lin thd 7 dugc dua ra nam

2009 da dugc chinh thdc ap dung.

Dd lieu sd dung dd danh gia, dua ra ban phan giai doan ung thu phdi lin nay dugc thu thip td 81015

trudng hgp sau khi da loai ra nhdng trudng hgp khdng du tieu chuin. Trong sd nay, ung thu tdbio nho

(SCLC): 16% va ung thu phdi khdng tdbio nho (NSCLC): 84%. Chico NSCLC dugc dung dd phin chia

T, N, M vi xdp nhdm giai doan. Dd lieu dugc thu thip a 4 chiu luc, trong dd Chiu Au: 58%, Bac My:

21%, Chiu A: 14%, Chiu Uc: 7%. VS diiu tri, phiu thuit dat: 41%, xa tri: 11%, hda chat: 23%, cdn lai

la cac bien phap diiu tri kdt hgp.

1. Lieh sir he thong xep giai doan quoc te ve

ung thu phdi

He thong xep giai doan TNM cho ung thu

phoi ban dau dugc de xuat bdi Bic sT Clifton

Mountain va da dugc AJCC thong qua vio nam

1973, UICC thong qua nam 1974. Sau do dugc

Lien iiy ban xep giai doan ung thu Hoa Ky sir

dung de dua ra khuyen cao xep giai doan lam

sing cho ung thu phdi khong te bio nho

(NSCLC). Miic do ciia benh dugc mo ta theo

khoi u tien phat (T: primary tumor): T0-T3, tinh

trang hach (N; nodal status): N0-N2, vl co hay

khong di can (M: metastasis): MO-Ml.

Nam 1985, AJCC, UICC, cle nha khoa hoc

Dire va Nhat Ban da dS xuat danh gil lai he

thong xep giai doan quoc tS cho ung thu phoi

dya tren phan tich 3 753 benh nhan. Trong phan

loai nly, xuat hien them phan nhom T4 vl N3

vdi dac diem:

- T4: khoi u xam lan vao nhirng cau trtic ciia

trung that hoac mot hoac nhiSu can true ciia than

dot song hoac tran dich mang phoi lc tinh.

* Khoa Ho hap Benh vien Bach Mai

** Khoa Ho hap Benh vien Da khoa tinh Hal Dwcfng

1 2 IY HOC LAM SANG Sd 45 (Thang 10/2009)