Non-Small Cell Lung Cancer Stages
非小細胞肺癌分期
After someone is diagnosed with non-small cell lung cancer (NSCLC), doctors will try to figure out if it has spread, and if so, how far. This is called staging or finding the cancer's stage.
在某人被診斷出患有非小細胞肺癌（NSCLC）後，醫生將試圖確定癌細胞是否擴散，如果是的話，擴散的程度如何。這被稱為分期或尋找癌症的階段。
How is the stage determined?
階段是如何確定的？
This process is called staging. The stage of a cancer describes how much and where the cancer is in the body. It helps determine how best to treat it. Doctors also use a cancer’s stage when talking about survival statistics.
這個過程被稱為分期。癌症的分期描述了癌症在身體中的程度和位置。它有助於確定最佳的治療方法。醫生在談論生存統計時也使用癌症的分期。
The earliest stage of NSCLC is stage 0 (also called carcinoma in situ, or CIS). Other stages range from I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. And within a stage, an earlier letter (or number) means a lower stage. Although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way.
非小細胞肺癌的最早期是 0 期（也稱為原位癌或 CIS）。其他期別從 I 期（1）到 IV 期（4）。一般而言，數字越低，癌症擴散越少。而較高的數字，如 IV 期，表示癌症擴散更多。在同一期別中，較早的字母（或數字）表示較低的期別。雖然每個人的癌症經歷是獨特的，但具有相似期別的癌症往往有相似的預後，並且通常以相似的方式進行治療。
The staging system most often used for NSCLC is the American Joint Committee on Cancer (AJCC) TNM system, which is based on 3 key pieces of information:
最常用於非小細胞肺癌(NSCLC)的分期系統是美國癌症聯合委員會(AJCC) TNM 系統，該系統基於三個關鍵信息：
- The size and extent of the main tumor (T): How large is the tumor? Has it grown into nearby structures or organs?
主要腫瘤的大小和範圍（T）：腫瘤有多大？它是否擴展到附近的結構或器官中？ - The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes? (See image.)
附近淋巴結的擴散（N）：癌症是否擴散到附近的淋巴結？（見圖片。） - The spread (metastasis) to distant sites (M): Has the cancer spread to distant organs, such as the brain, bones, adrenal glands, liver, the pleural fluid, or the other lung?
癌症是否蔓延到遠端器官，如腦部、骨骼、腎上腺、肝臟、胸腔液或另一肺部？
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage. For more information, see Cancer Staging.
T、N 和 M 后面的数字或字母提供了关于每个因素的更多细节。数字越高，表示癌症越晚期。一旦确定了一个人的 T、N 和 M 类别，这些信息将在一个称为分期分组的过程中结合起来，以确定一个总体分期。有关更多信息，请参阅癌症分期。
The system described below is the most recent version of the AJCC system, effective as of January 2018.
下面描述的系統是 AJCC 系統的最新版本，自 2018 年 1 月起生效。
NSCLC is typically given a clinical stage based on the results of a physical exam, biopsy, and imaging tests (as described in Tests for Lung Cancer). If surgery is done, the pathologic stage (also called the surgical stage) is determined by examining tissue removed during the operation.
非小細胞肺癌通常根據體格檢查、活體組織檢查和影像檢查（如肺癌檢測）的結果來確定臨床分期。如果進行手術，則通過檢查手術過程中切除的組織來確定病理分期（也稱為手術分期）。
Staging for NSCLC can be complex, so ask your doctor to explain it to you in a way you understand.
非小細胞肺癌的分期可能很複雜，所以請向您的醫生要求以您能理解的方式解釋。
Stages of non-small cell lung cancer
非小細胞肺癌的階段
AJCC Stage AJCC 分期 |
Stage grouping 分期分組 |
Stage description* 階段描述* |
Occult (hidden) cancer 隱藏性癌症 |
TX N0 M0 |
The main tumor can’t be assessed for some reason, or cancer cells are seen in a sample of sputum or other lung fluids, but the cancer isn’t found with other tests, so its location can’t be determined (TX). The cancer is not thought to have spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
0 |
Tis N0 M0 |
The tumor is found only in the top layers of cells lining the air passages, but it has not invaded deeper into other lung tissues (Tis). The cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
IA1 |
T1mi N0 M0 |
The cancer is a minimally invasive adenocarcinoma. The tumor is no larger than 3 centimeters (cm) across, and the part that has invaded into deeper lung tissues is no more than ½ cm across. The cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
OR |
||
T1a N0 M0 |
The tumor is no larger than 1 cm across, it has not reached the membranes that surround the lungs, and it does not affect the main branches of the bronchi (T1a). The cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
|
IA2 |
T1b N0 M0 |
The tumor is larger than 1 cm but no larger than 2 cm across. It has not reached the membranes that surround the lungs, and it does not affect the main branches of the bronchi (T1b). The cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
IA3 |
T1c N0 M0 |
The tumor is larger than 2 cm but no larger than 3 cm across. It has not reached the membranes that surround the lungs, and it does not affect the main branches of the bronchi (T1c). The cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
IB |
T2a N0 M0 |
The tumor has one or more of the following features (T2a):
The cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
IIA |
T2b N0 M0 |
The tumor has one or more of the following features (T2b):
The cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
IIB |
T1a/T1b/T1c N1 M0 |
The tumor is no larger than 3 cm across, has not grown into the membranes that surround the lungs, and does not affect the main branches of the bronchi (T1). It has spread to lymph nodes within the lung and/or around the area where the bronchus enters the lung (peribronchial, hilar, or intrapulmonary lymph nodes). These lymph nodes are on the same side as the cancer (N1). The cancer has not spread to distant parts of the body (M0). |
OR |
||
T2a/T2b N1 M0 |
The tumor has one or more of the following features (T2):
The cancer has also spread to lymph nodes within the lung and/or around the area where the bronchus enters the lung (peribronchial, hilar, or intrapulmonary lymph nodes). These lymph nodes are on the same side as the cancer (N1). The cancer has not spread to distant parts of the body (M0). |
|
OR |
||
T3 N0 M0 |
The tumor has one or more of the following features (T3):
The cancer has not spread to nearby lymph nodes (N0) or distant parts of the body (M0). |
|
IIIA |
T1a/T1b/T1c N2 M0 |
The cancer is no larger than 3 cm across, has not grown into the membranes that surround the lungs, and does not affect the main branches of the bronchi (T1). The cancer has spread to lymph nodes below the carina (the point where the windpipe splits into the left and right bronchi) or in the space between the lungs (mediastinum). These lymph nodes are on the same side as the main lung tumor (N2). The cancer has not spread to distant parts of the body (M0). |
OR |
||
T2a/T2b N2 M0 |
The tumor has one or more of the following features (T2):
The cancer has spread to lymph nodes below the carina (the point where the windpipe splits into the left and right bronchi) or in the space between the lungs (mediastinum). These lymph nodes are on the same side as the main lung tumor (N2). The cancer has not spread to distant parts of the body (M0). |
|
OR |
||
T3 N1 M0 |
The tumor has one or more of the following features (T3):
The cancer has also spread to lymph nodes within the lung and/or around the area where the bronchus enters the lung (peribronchial, hilar, and intrapulmonary lymph nodes). These lymph nodes are on the same side as the cancer (N1). The cancer has not spread to distant parts of the body (M0). |
|
OR |
||
T4 N0 or N1 M0 |
The tumor has one or more of the following features (T4):
The cancer may or may not have spread to lymph nodes within the lung and/or around the area where the bronchus enters the lung (peribronchial, hilar, or intrapulmonary lymph nodes). Any affected lymph nodes are on the same side as the cancer (N0 or N1). The cancer has not spread to distant parts of the body (M0). |
|
IIIB
|
T1a/T1b/T1c N3 M0 |
The cancer is no larger than 3 cm across, has not grown into the membranes that surround the lungs, and does not affect the main branches of the bronchi (T1). The cancer has spread to lymph nodes above the collarbone on either side of the body, and/or has spread to hilar or mediastinal lymph nodes on the other side of the body from the main tumor (N3). The cancer has not spread to distant parts of the body (M0). |
OR |
||
T2a/T2b N3 M0 |
The tumor has one or more of the following features (T2):
The cancer has spread to lymph nodes above the collarbone on either side of the body, and/or has spread to hilar or mediastinal lymph nodes on the other side of the body from the main tumor (N3). The cancer has not spread to distant parts of the body (M0). |
|
OR |
||
T3 N2 M0 |
The tumor has one or more of the following features (T3):
The cancer has spread to lymph nodes below the carina (the point where the windpipe splits into the left and right bronchi) or in the space between the lungs (mediastinum). These lymph nodes are on the same side as the main lung tumor (N2). The cancer has not spread to distant parts of the body (M0). |
|
OR |
||
T4 N2 M0 |
The tumor has one or more of the following features (T4):
The cancer has spread to lymph nodes below the carina (the point where the windpipe splits into the left and right bronchi) or in the space between the lungs (mediastinum). These lymph nodes are on the same side as the main lung tumor (N2). The cancer has not spread to distant parts of the body (M0). |
|
IIIC |
T3 N3 M0 |
The tumor has one or more of the following features (T3):
The cancer has spread to lymph nodes above the collarbone on either side of the body, and/or has spread to hilar or mediastinal lymph nodes on the other side of the body from the main tumor (N3). The cancer has not spread to distant parts of the body (M0). |
OR |
||
T4 N3 M0 |
The tumor has one or more of the following features (T4):
The cancer has spread to lymph nodes above the collarbone on either side of the body, and/or has spread to hilar or mediastinal lymph nodes on the other side of the body from the main tumor (N3). The cancer has not spread to distant parts of the body (M0). |
|
IVA |
Any T Any N M1a |
The cancer can be any size and may or may not have grown into nearby structures (any T). It may or may not have reached nearby lymph nodes (any N). In addition, any of the following is true (M1a):
|
OR |
||
Any T Any N M1b |
The cancer can be any size and may or may not have grown into nearby structures (any T). It may or may not have reached nearby lymph nodes (any N). It has spread as a single tumor outside of the chest, such as to a distant lymph node or an organ such as the liver, bones, or brain (M1b). |
|
IVB |
Any T Any N M1c |
The cancer can be any size and may or may not have grown into nearby structures (any T). It may or may not have reached nearby lymph nodes (any N). It has spread as more than one tumor outside the chest, such as to distant lymph nodes and/or to other organs such as the liver, bones, or brain (M1c). |
*The following additional categories are not listed in the table above:
- T0: There is no evidence of a primary tumor.
- NX: Nearby lymph nodes cannot be assessed due to lack of information.
- Written by
- References
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
Last Revised: January 29, 2024
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
American Cancer Society Emails
Sign up to stay up-to-date with news, valuable information, and ways to get involved with the American Cancer Society.
