喉癌 TNM 分期英文版 Primary tumor (T) TX: Primary tumor cannot be assessed T0: No evidence of primary tumor Tis: Carcinoma in situ Supraglottis T1: Tumor limited to one subsite* of supraglottis with normal vocal cord mobility T2: Tumor invades mucosa of more than one adjacent subsite* of supraglottis or glottis or region outside the supraglottis (e.g., mucosa of base of tongue, vallecula, or medial wall of pyriform sinus) without fixation of the larynx T3: Tumor limited to larynx with vocal cord fixation and/or invades any of the following: postcricoid area, pre-epiglottic tissues, paraglottic space, and/or minor thyroid cartilage erosion (e.g., inner cortex) T4a: Tumor invades through the thyroid cartilage, and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of the neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus) T4b: Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures Subsites include the following: Ventricular bands (false cords) Arytenoids Suprahyoid epiglottis Infrahyoid epiglottis Aryepiglottic folds (laryngeal aspect) Note: Supraglottis involves many individual subsites. Relapse-free survival may differ by subsite and by T and N groupings within stage.Glottis T1: Tumor limited to the vocal cord(s), which may involve anterior or posterior commissure, with normal mobility T1a: Tumor limited to one vocal cord T1b: Tumor involves both vocal cords T2: Tumor extends to supraglottis and/or subglottis and/or with impaired vocal cord mobility T3: Tumor limited to the larynx with vocal cord fixation and/or invades paraglottic space, and/or minor thyroid cartilage erosion (e.g., inner cortex) T4a: Tumor invades through the thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck, including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus) T4b: Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures Note: Glottic presentation may vary by volume of tumor, anatomic region involved, and the presence or absence of normal cord mobility. Relapse-free survival may differ by these and other factors in addition to T and N subgroupings within the stage.Subglottis T1: Tumor limited to the subglottis T2: Tumor extends to vocal cord(s) with normal or impaired mobility T3: Tumor limited to larynx with vocal cord fixation T4a: Tumor invades cricoid or thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck, including deep extrinsic muscles of the tongue, strap muscles, thyroid, or esophagus) T4b: Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures Regional lymph nodes (N) NX: Regional lymph nodes cannot be assessed N0: No regional lymph node metastasis N1: Metastasis in a single ipsilateral lymph node 3 cm or smaller in greatest dimension N2: Metastasis in a single ipsilateral lymph node larger than 3 cm but 6 cm or smaller in greatest dimension, or in multiple ipsilateral lymph nodes 6 cm or smaller in greatest dimension, or in bilateral or contralateral lymph nodes 6 cm or smaller in greatest dimension N2a: Metastasis in a single ipsilateral lymph node larger than 3 cm but 6 cm or smaller in greatest dimension N2b: Metastasis in multiple ipsilateral lymph nodes 6 cm or smaller in greatest dimension N2c: Metastasis in bilateral or contralateral lymph nodes 6 cm or smaller in greatest dimension N3: Metastasis in a lymph node larger than 6 cm in greatest dimension In clinical evaluation, the actual size of the nodal mass should be measured, and allowance should be made for intervening soft tissues. Most masses larger than 3 cm in diameter are not single nodes but confluent nodes or tumors in soft tissues of the neck. There are three stages of clinically positive nodes: N1, N2, and N3. The use of subgroups a, b, and c is not required but recommended. Midline nodes are considered homolateral nodes. Distant metastasis (M) MX: Distant metastasis cannot be assessed M0: No distant metastasis M1: Distant metastasis AJCC Stage Groupings Stage 0 Tis, N0, M0 Stage I T1, N0, M0 Stage II