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Cancer treatment begins with diagnosis and determination of the stage of the disease. The result of oncotherapy and the prognosis for recovery depend on this. In order to properly systematize the data and select the most effective program to combat this pathology, a unified International Cancer Classification System was created.
This document is the key to the productive interaction of all medical professionals who treat cancer. It allows them to clearly determine at what stage of development is the tumor, its location, how far this process has spread and which organs are involved in it. And as a result, choose the optimal method and volume of surgery, as well as the type of chemotherapy and/or radiotherapy for cancer cells.
For a person who is not related to the medical field, to deal with this classification is quite difficult. Therefore, we have prepared this article to help you understand what the numbers and letters mean in oncological diagnosis.
MEANING OF SYMBOLS “TNM”
International classification of cancers, which is used by oncologists, contains TNM-symbols , which determine the anatomical prevalence of a malignant neoplasm . These letters mean:
T (tumor from the Latin “swelling”) – primary tumor size;
N (nodus from the Latin “node”) – the involvement of the regional lymph nodes;
M (metastasis from Latin “metastases”) – presence of spread in distant organs or tissues.
The numbers that stand next to the symbols indicate the degree of prevalence of a malignant tumor. For example, for the T character, the numbers 0-4 have the following meaning:
T0 – no data on the primary tumor;
T1 is a small-sized neoplasm, developing on the affected organ without germinating deep into;
T2 – a medium-sized tumor that does not extend beyond the boundaries of the affected organ and does not grow into;
T3 – a large infiltrating neoplasm spreading in an organ;
T4 – neoplasm of any size, which extends to other organs and tissues.
For N (lymph nodes), the numbers 0-3 mean:
N0 – absence of affected lymph nodes;
N1 – 1 regional lymph node is affected;
N2 – a group of regional lymph nodes is affected;
N3 – distant lymph nodes affected.
Meaning of 0-1 character M (the presence of metastases in other organs) is interpreted as:
M0 – distant metastases not found;
M1 – detected distant metastases.
The exact number of metastases M is not indicated. They are either there or they are not. Therefore, М1 can mean the presence in the body of not one source of metastases, but several.
Examples of decoding oncological diagnosis:
T1N0M0 – stage 1 cancer, without affected lymph nodes and metastases;
T1N1M0 – stage 2 cancer with a single lesion of the lymph nodes;
T3N2M0 – stage 3 cancer with multiple lymph nodes affected;
T4N3M1 is a stage 4 cancer with multiple lesions of the regional & distant lymph nodes and metastases in other organs.
CLASSIFICATION OF TNM TUMORS: SPECIFIC SYMBOLS
If, in addition to the letters in the TNM classification, you meet additional characters, they are interpreted as:
TX – means the presence of a primary tumor, which for technical reasons cannot be determined;
Tis – the initial stage of the formation of cancer cells (“nucleation” of the tumor);
NX – damage to the lymph nodes cannot be established;
L – damage to the lymphatic ducts (vessels);
V – a malignant neoplasm affecting large veins;
Pn – tumor germination in the nerve.
CLASSIFICATION OF ONCOLOGICAL DISEASES BY HISTOLOGIC STRUCTURE
The smaller (poorly differentiated) cancer cells, the more dangerous they are. Such tumors are characterized by rapid growth and a high degree of metastasis. According to the degree of malignancy or the histological structure (the G symbol is used for designation), oncological diseases are divided into the following types:
G1 is a highly differentiated cancer that rarely metastasizes;
G2 – moderately differentiated neoplasm;
G3-4 – cancer cells with a low degree of differentiation, characterized by a high level of malignancy;
GX – the degree of malignancy is impossible to determine.
To classify the degree of malignancy in cases of soft tissue sarcoma and bone, the G symbol is not used. In this case, they write: a tumor with a high degree of malignancy or with a low one.
CLASSIFICATION OF POSTOPERATIVE TUMORS
It is possible to judge the effectiveness of oncotherapy by the presence or absence of residual cancer cells. Therefore, for the classification of postoperative tumors, the symbol R is used, which means:
R0 – absence of cancer (patient is actually healthy);
R1 – the presence of residues of a microscopic tumor size;
R2 – the presence of residues of a tumor of macroscopic size;
RX – there is no way to assess the presence of a tumor.
If the tumor is not completely removed “en blok”, but in parts, then there may be some difficulties with the R-classification. In such cases, category RX is used.
CLASSIFICATION OF TUMORS BY TYPE OF TISSUE
Malignant tumors are classified according to the type of tissue from which they are formed. Depending on this criterion, cancers are divided into the following types:
Tumor originating from the connective tissue, which includes bones, adipose tissue, cartilage and blood (fibrosarcoma, liposarcoma, chondrosarcoma, osteosarcoma);
Cancer developing from muscular tissue (myosarcoma);
Vascular tumors (angioblastoma);
Cancer of nervous tissue (medulloblastoma, ganglioblastoma, neuroblastoma, astrocytoma);
Cancer developed from blood cells (lymphosarcoma, lymphoma);
Cancer formed from pigment cells (melanoma);
Mixed tumors (teratoblastoma).
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