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1 암등록지침서개정 (2012) 최혜경

2 순 서 지침개정사항 1. 필수등록항목추가 - 진단경로 - 편측성 - 분화도 - 전이부위 2. 애매모호한용어정의 3. 기타변경사항 ICD-O-3 update

3 필수등록항목추가 1. 진단경로 암진단받은경로를코드로입력 코드 구분 1 검진 2 우연한발견 ( 수술시검사하면서 ) 3 증상발현 ( 임상적발현 ) 4 미상 5 기타 * 타병원에서진단받고전원된경우도 1~4 분류 * 기타는자세한내용 text로필수입력

4 필수등록항목추가 2. 편측성 (Laterality) 쌍을이룬장기의원발부위에대한정확한암등록자료수집위해추가 코드 설명 0 쌍을이룬장기가아님 1 오른쪽 2 왼쪽 3 오른쪽 / 왼쪽이원발부위인지확인되지않은한쪽침범 4 진단시하나의원발부위에대해양쪽침범 5 정중선 (midline) 종양 9 편측성에대한정보가없는경우

5 필수등록항목추가. 2. 편측성 (Laterality) 편측성코드 (1~5, 9) 를분류하는원발부위 ( 치침서 p37) ICD-O-3 코드원발부위 KCD-6 코드 C07.9 C08.0 C C C50.9 C C72.4 C72.5 C C74.9 C75.4 Parotid gland Submandibular gland Sublingual gland... Breast Ovary... Acoustic nerve Cranial nerve, NOS Adrenal gland Carotid body C07 C08.0 C C C50.99 C C C72.4 C72.5 C C74.9 C75.4

6 필수등록항목추가 2. 편측성 (Laterality) 모든부위에대해필수적으로사용 : 0-5, 9 로코딩 코드 설명 0 표에제시되지않은원발부위 - Thyroid gland, prostate, stomach, colon 등 - 원발부위를모르는경우 (C80.9) 4 - 단일조직학적진단명, 동시에양쪽난소가침범된악성종양 - 양측망막아종 (retinoblastomas) - 양측윌름성종양 (Wilms' tumor) 9 쌍을이룬장기 ; 편측성에대한정보가없는경우 - Lung ca, NOS 예1: Patient has a midline meningioma of the cerebral meninges 의편측성분류코드는? 5

7 필수등록항목추가 3. 분화도 (Grade) - 종양이발생한원발조직과얼마나유사한정도나타냄 - 림프종, 백혈병의세포계보표현형 : T-, B-, Null-, NK-cell 분화도 : 조직학적검사로 grade, differentiation 으로나타냄 Grade 1- Well differentiated: 고분화성, 원발조직과밀접히닮음 Grade 2- Moderately differentiated: 중증분화성, 중간정도닮음 Grade 3- Poorly differentiated: 저분화성, 원발조직과조금비슷 Grade 4- Undifferentiated: 미분화성, 퇴화원발조직과전혀다르게 조직이파괴되고, 비정상 - 분화도가두가지로기술된경우높은번호로코딩예 ) Adenocarcinoma, poorly with moderately differentiated

8 필수등록항목추가 코드 3. 분화도 (Grade) 구분 1 Grade I, grade 1; well differentiated; differentiated NOS 2 Grade II, grade 2; moderately differentiated; moderately well differentiated; intermediate differentiation 3 Grade III, grade 3; poorly differentiated; dedifferentiated 4 Grade IV, grade 4; undifferentiated; anaplastic 5 T-cell, T-precursor 6 B-Cell, Pre-B, B-precursor 7 Null cell, Non T- non B 8 NK cell (natural killer cell) 9 Grade/differentiations unknown, not stated, or not applicable

9 필수등록항목추가 4. 전이부위 원격전이된부위가확인되면전이부위를 ICD-O-3 코드로입력 (3 개까지 ) 예 ) 유방암이폐와척추뼈, 뇌에전이된경우 전이부위 C349 C412 C719

10 5. 애매모호한용어정의 암으로간주되는용어 Comparable with Consistent with Compatible with Favors Most likely Typical of 주치의와협의필요한용어 Malignant appearing Suggests 병리학회설문조사결과 (2007 년 )

11 변경사항 6. PAP smear 분류시스템 Class Dysplasia CIN The Bethesda System(TBS) Ⅰ Benign Benign Normal CINⅢ or High-grade SIL with Severe dysplasia 경우 : 암등록 Ⅱ Benign with Inflammation Benign with inflammation Normal Ⅲ Mild dysplasia CINⅠ Low-grade SIL Ⅲ Moderate dysplasia CIN Ⅱ Ⅲ Ⅳ Severe dysplasia Carcinoma in situ (CIS) CIN Ⅲ High-grade SIL Ⅴ Invasive carcinoma Invasive carcinoma Invasive carcinoma * CIN : Cervical intraepithelial neoplasia * SIL : Squamous intraepithelial lesion * 녹색처리된부분 : 등록대상 * 대한병리학회 : 1998 년부터 TBS 분류를따름

12 변경사항 7. 뇌종양등록시변경사항 MRI 등의비현미경적방법으로진단된경우 : M8000/0 ~ M8000/3 구체적인형태학적코드입력 예제 1) Brain MRI: Well enhancing lesions in the third ventricle, fourth ventricle, and sella. most likely germinoma *M8000/3 M9064/3 예제 2) Brain MRI: Pituitary adenoma *M8000/0, M8140/0 M8272/0

13 ICD-O-3 update 개요 신설코드 (New code and Term) 기존코드에추가 (Code and New term) 새로운대표용어 (New preferred term) 형태학적코드의변경 (/1 /3) ICD-O-2 코드의재사용 (Code restored) 코드의삭제 (Delete code and term) 동의어, 약어추가

14 ICO-O-3 Update New code and Term 1 New code Term 8163/2 Papillary neoplasm, pancreatobiliary-type, with high grade intraepithelial neoplasia (C24.1) 8163/3 Pancreatobiliary-type carcinoma (C24.1) 8213/3 Serrated adenocarcinoma 8265/3 Micropapillary carcinoma, NOS (C18._, C19.9, C20.9) 8552/3 Mixed acinar-ductal carcinoma 9395/3 Papillary tumor of the pineal region 9425/3 Pilomyxoid astrocytoma 9597/3 Primary cutaneous follicle centre lymphoma 9724/3 Systemic EBV positive T-cell lymphoproliferative disease of childhood

15 ICO-O-3 Update New code New code and Term 2 Term 9726/3 Primary cutaneous gamma-delta T-cell lymphoma 9735/3 Plasmablastic lymphoma 9737/3 ALK positive large B-cell lymphoma 9738/3 Large B-cell lymphoma arising in HHV8-associated multicentric Castleman disease 9759/3 Fibroblastic reticular cell tumor 9966/3 Myeloid neoplasms with PDGFRB rearrangement 9967/3 Myeloid and lymphoid neoplasms with FGFR1 abnormalities 9971/3 Polymorphic post transplant lymphoproliferative disorder 9975/3 Myeloproliferative neoplasm, unclassifiable 9991/3 Refractory neutropenia 9992/3 Refractory thromocytopenia

16 ICO-O-3 Update Code and New term Code New term 8150/3 Pancreatic endocrine tumor, malignant/nonfunctioning 8154/3 Mixed pancreatic endocrine and exocrine tumor, malignant (C25._) Mixed acinar-endocrine-ductal carcinoma 8201/3 Cribriform comedo-type carcinoma (C18._, C19.9, C20.9) 8453/3 Intraductal papillary mucinous neoplasm with an associated invasive carcinoma 8470/3 Mucinous cystic tumor with an associated invasive carcinoma (C25._) 8490/3 Poorly cohesive carcinoma 8503/3 Intraductal papillary neoplasm with associated invasive carcinoma 8970/3 Hepatoblastoma, epithelioid Hepatoblastoma mixed epithelial-mesenchymal (C22.0) 9471/3 Medulloblastoma with extensive nodularity 9474/3 Anaplastic medulloblastoma

17 ICO-O-3 Update New preferred term Code New preferred Term 8077/2 Squamous intraepithelial neoplasm, high grade Move former preferred term to synonym Squamous intraepithelial neoplasia, grade III 8150/3 Pancreatic endocrine tumor, malignant Islet cell tumor, NOS (C25._) 8154/3 Mixed pancreatic endocrine and exocrine tumor, malignant (C25._) Mixed islet cell and exocrine adenocarcinoma (C25._) 8244/3 Mixed adenoneuroendocrine carcinoma Composite carcinoid 9716/3 Hepatosplenic T-cell lymphoma Hepatosplenic gamma-delta cell lymphoma 9858/3 Acute myeloid leukemia with myelodysplasiarelated changes Acute myeloid leukemia with multilineage dysplasia 9920/3 Therapy related myeloid neoplasm Therapy-related acute myeloid leukemia, NOS 9960/3 Myeloproliferative neoplasm, NOS Chronic myeloproliferative disease, NOS 9961/3 Primary myelofibrosis Myelolsclerosis with myeloid metaplasia 9964/3 Chronic eosinophilic leukemia, NOS Hypereosinophilic syndrome

18 ICO-O-3 Update High grade dysplasia/neoplasia Code Term 8148/2 Glandular intraepithelial neoplasia, high grade Flat intraepithelial glandular neoplasia, high grade (C24.1) Flat intraepithelial neoplasia (dysplasia), high grade (C24.1) Biliary intraepithelial neoplasia, high grade Esophageal glandular dysplasia (intraepithelial neoplasia), high grade (C15._) Esophageal intraepithelial neoplasia, high grade (C15._) *8077/2, 8163/2, 8453/2, 8470/2, 8503/2 도추가 *C15._, C22._, C23.9, C24.1, C25._ 의원발부위만해당 * 다른부위는주치의, 병리의사와협의후등록

19 ICO-O-3 Update NET 의 ICD-O-3 비교 ICD-O-3 New Term Term 8013/3 Large cell neuroendocrine carcinoma 8041/3 Small cell neuroendocrine carcinoma 8240/3 Neuroendocrine tumor, grade 1 Neuroendocrine carcinoma, low grade/ well differentiated 8244/3 Mixed adenoneuroendocrine carcinoma MANEC Carcinoid tumor NOS Typical carcinoid tumor Bronchial adenoma, carcinoid(c34._) Composite carcinoid Combined carcinoid and adenocarcinoma Mixed carcinoid adenocarcinoma 8246/3 Neuroendocrine carcinoma, NOS 8249/3 Neuroendocrine tumor, grade 2 Neuroendocrine carcinoma, moderately differentiated Atypical carcinoid tumor 8574/3 Adenocarcinoma with neuroendocrine differentiation *stomach, intestine, appendix, pancreas, lung *NET: Neuroendocirne Tumors

20 ICO-O-3 Update NET 의장기별병기 (AJCC 7 th ) Appendix T1: 2 cm T1a: 1 cm T1b: 1 ~ 2 cm T2: 2 ~ 4 cm or cecum T3: > 4 cm or ileum T4 : Perforates peritoneum; other organs, structures Small Intestine T1: LP/ Submucosa and 1 cm T2: Muscularis propria or > 1 cm T3: Jejunal, ileal: subserosa Ampullary, duodenal: pancreas or retroperitoneum T4: Perforates serosa; visceral peritoneum or other organ Stomach Tis: < 0.5 mm confined to mucosa T1: LP or submucosa & 1 cm T2: Muscularis propria or > 1 cm T3: Subserosa T4: Perforates serosa; visceral peritoneum or adjacent structures Large Intestine T1: LP or submucosa or 2cm T1a: 1 cm T1b: 1 ~ 2 cm T2: Muscularis propria or > 2cm T3: Subserosa, or percolic/ perirectal tissues T4: Perforates serosa; peritoneum or other organ

21 ICO-O-3 Update Langerhans cell histiocytosis 9751/1 9752/1 9753/1 9754/3 Langerhans cell histiocytosis, NOS Langerhans cell granulomatosis Histiocytosis X, NOS Langerhans cell histiocytosis, unifocal Langerhans cell histiocytosis, mono-ostotic Langerhans cell granulomatosis, unifocal Eosinophilic granuloma Langerhans cell histiocytosis, multifocal Langerhans cell histiocytosis, poly-ostotic Hand-Schuller-Christian disease Langerhans cell histiocytosis, disseminated Langerhans cell histiocytosis, generalized Letterer-Siwe disease Acute progressive histiocytosis X Nonlipid reticuloendotheliosis C96.6 C96.6 C96.5 C /3 C96.08, C96.00

22 ICO-O-3 Update Code restored (ICD-O-2) 9680/3 9688/3 T-cell/histiocyte rich large B-cell lymphoma Histocyte-rich large B-cell lymphoma T-cell rich/histiocyte-rich large B-cell lymphoma 9680/3 9712/3 Intravascular large B-cell lymphoma (C49.9) Intravascular B-cell lymphoma Angioendotheliomatosis Angiotropic lymphoma

23 ICO-O-3 Update Behavior code change( /1 /3) 기존코드 Term 변경코드 Carcinoid tumor NOS, of appendix 8240/1 8240/3 Carcinoid NOS, of appendix(c18.1) T-cell large granular lymphocytic leukemia 9831/1 T-cell large granular lymphocytosis NK-cell large granular lymphocytic leukemia 9831/3 Large granular lymphocytosis, NOS 9975/1 Myeloproliferative disease, NOS 9960/3

24 ICO-O-3 Update Delete code and term 삭제코드 Term 변경코드 8157/1 Enteroglucagonoma, NOS 8152/1 8157/3 Enteroglucagonoma, malignant 8152/3 Intraductal papillary-mucinous tumor with 8453/1 8453/0 moderate dysplasia (C25.1) Mucinous cystic tumor with moderate 8470/1 8470/0 dysplasia (C25._) 9975/1 Myeloproliferative disease, NOS 9960/3

25 ICO-O-3 Update 암등록을해야하는용어 1 Term Systemic mastocytosis with associated hematological clonal non-mast cell disorder (D47.0) Code 9741/3 Indeterminate dendritic cell tumor 9757/3 Fibroblastic reticular cell tumor 9759/3 Chronic lymphoproliferative disorder of NK cells (D47._) 9831/3 Therapy related myeloid neoplasm 9920/3 Myeloproliferative neoplasm/disease, NOS 9960/3

26 ICO-O-3 Update 암등록을해야하는용어 2 Term Code Primary myelofibrosis 9961/3 Myeloid and lymphoid neoplasms with PDGFRA rearrangement 9965/3 Myeloid neoplasms with PDGFRB rearrangement 9966/3 Myeloid and lymphoid neoplasms with FGFR1 abnormalities 9967/3 Polymorphic post transplant lymphoproliferative disorder 9971/3 Myeloproliferative neoplasm, unclassifiable 9975/3 Refractory neutropenia 9991/3 Refractory thrombocytopenia 9992/3

27 ICO-O-3 Update New code 8158/1 Brain tumor 1 Term Endocrine tumor, functioning, NOS ACTH-producing tumor 9395/3 Papillary tumor of the pineal region 9425/3 Pilomyxoid astrocytoma 9431/1 Angiocentric glioma 9432/1 Pituicytoma 9509/1 Papillary glioneuronal tumor Rosette-forming glioneuronal tumor * 뇌종양위원회자문

28 ICO-O-3 Update Brain tumor 2 기존코드에추가 Code 8290/0 Term Spindle cell oncocytoma (C75.1) 9471/3 Medulloblastoma with extensive nodularity 9474/3 Anaplastic medulloblastoma 9506/1 Extraventricular neurocytoma 9680/3 Primary diffuse large B-cell lymphoma of the CNS (C70._, C71._, C72._) * 뇌종양위원회자문

29 암등록자료의질관리

30 암등록자료의질지표 비교성발생일정의발생정의코드체계사용완벽성자료소스독립적인환자색출역사적인자료방법타당성진단기준방법결측정보재발췌및재코드화방법내적일관성방법 발생일정의, 우선순위다중원발암정의 ICD-O-3 진단방법 (HV%, MV%) 시간경과 ( 월, 년 ) 에따른추이 PSU% 등 Specific site / routine cases Logical validity check

5% (not acceptable: < 75%) Mortality/Incidence ratio : 0.554 (acceptable: 0.3~0.

31 Population: 46,000,000 Death Certificate Only : 5.9% (not acceptable: > 20%) Microscopic Verification : 75.5% (not acceptable: < 75%) Mortality/Incidence ratio : (acceptable: 0.3~0.7) Males Females No. of all cancer cases 243, ,902 Age Standardized Rate Morphology Verification % 72.4% 79.0% Death Certificate Only % 6.0% 5.8% Mortality/Incidence % 61.8% 45.7%

32 시각적검토 필수항목의기재 항목별로정렬하여입력가능범위확인예 : 원발부위, 조직학적진단명, 초진일등 초진일, 원발부위, 조직학적분류... 순으로정렬 M code behavior /6인경우 ICD-10 코드사용예 : C43, C45-C46, C78-C79, C81-C97

33 자료입력의오류 주민등록번호행정적오류, 병원정보상입력오류, 암등록정보입력시오기 성명발음어렵거나연음이생기는이름외국인이름의한글화 성별주민번호일곱번째자리 1, > 남 / 2, > 여 코드 ex) 남자 C56.9(Ovary) -----> C65.9(Renal pelvis) 날짜 ( 생년월일, 초진일, 사망일 ) ex)

34 논리적검토 해당성별에흔하지않은직업 T code와 M code의부조화 성별과 T code/ M code의부조화 예 : 남자 (SEX=1) 면서여자장기 (C51-C58) Genital rhabdomyoma, Endometrial stromal sarcomas, Ovarian tumors, Placental tumors 예 : 여자 (SEX=2) 면서남자장기 (C60-C63) Queyrat erythroplasia, Testicular tumors

35 연령과 T code/ M code 의부조화 - 연령 15세미만등록시고려 (by ICCC : International Classification of childhood Cancer) - 연령 40세미만 : 부위코드 C61._ 이고, 조직학코드 814_ 고려 - 연령 20세미만 : 부위코드 C15._, C19._, C20._, C21._, C23._, C24._, C38.4, C50._, C53._, C54._, C55._ - 연령 20세미만 : 부위코드 C17._ 조직학 9590 이하 ( 즉 lymphoma가아닌 ) 고려 - 연령 20세미만 : 부위코드 C33._ 또는 C34._ 또는 C18._ 조직학 824_ 아닌경우 ( 즉 carcinoid가아닌 ) 고려 - 연령 45세이상 : 부위코드 C58._ 조직학이 9100 인경우고려 - 연령 25세이거나미만 : 조직학이 9732, 9823인경우고려

36 진단방법과 M code - 비현미경적진단방법 (1-4) 으로진단받았고, 조직학적진단명 으로인정되는 22 가지이외의 M code 진단방법과 T code 진단방법 7 또는 8 로진단, 원발부위가 C80.9 시간적일관성 생년월일 < 초진일 < 사망일 T code 선정시주의해야할 M code Ovary(C56.9) 의 Krukenberg tumor(m8400/6) Peritoneum 의 Pseudomyxoma peritonei(m8480/6)

37 T code 와 Behavior: 2(in-situ) 의발생고려 C40._ C41._ C42._ C47._ C49._ C70._ C71._ C72._ 병기, 진단방법, 치료방법 - 병원자체등록인경우, 중앙암등록본부표준지침으로변환 - SEER summary staging 항목에 6, 8 의값불가 - 진단방법 8( 부검으로진단 ) 이라면사망일게재고려 - 진단방법 0(Death Certificate Only), 9(Unknown) 사용안함 - 치료방법순서준수 (surgery, chemo, radiation, immuno, hormone)

38 IARC Check Cancer Incidence in Five Continents Vol. VI 을위해암등록자료를제출한전세계의암등록자료를평가하기위해국제암연구소 (IARC) 에서개발 (1992 년 ) 발생률산출에필요한자료항목만을검토 성별, 나이, 생일, 초진일, 원발부위, 조직학적진단, 진단방법 자료의타당도 ( 개별자료항목의정확도 ) 와일치도 ( 항목간의정확도 ) 를검정

39 IARCcrg Tools 국제암연구소 (IARC) 에서개발된프로그램으로암등록담당자가자료를변환하고, 확인하는것을돕기위해개발된 windows-based package 홈페이지 ( iacr.com.fr/iarccrgtools.htm) 에서무료로다운받을수있음 Code Conversion, IARC Check, Multiple Primary 고정 format 의텍스트파일을읽어검토

CanReg 5 인구집단기반의암등록사업을위해국제암연구소 (IARC) 에서개발 홈페이지 (http://www.

40 CanReg 5 인구집단기반의암등록사업을위해국제암연구소 (IARC) 에서개발 홈페이지 ( iacr.com.fr) 에서다운로드 입력자료의내용검증과확인작업에유용하며, 중복자검색, 다중원발암구분및발생률계산가능

41 Korean Software Program CANCER 중앙암등록본부의암등록자료수집위한입력프로그램 국립암센터 ( 에서다운로드후설치사용 우리나라암등록자료구조, 주민번호, 항목간부조화확인용이

42 예제 주민번호 & 성별 주민번호 수정후 성별 오류사항 날짜오류 날짜오류 자리다입력안함 번째성별오류 주민번호 7번째자리와성별이맞지않음 조합은맞으나주민번호오류체크프로그램상오류 이름오류 주민번호 이름 수정후 체크사항 구성자 구성자 공란없이다붙여서입력 진성주1 진성주 숫자나다른문자없이이름만입력 명윤자애기 이진호 해당환자이름입력

43 날짜 초진일수정후체크사항 일에서 30 일이상인자료체크 (1, 3, 5, 7, 8, 10, 12 월은 31 일임 ) 자리수에러 월은 12 월까지만 일의경우 4 의배수인년도만올수있음 주소 주소1 주소 1 수정후 체크사항 경기도부천시소사구괴안동 부천시소사구괴안동 도와시가같이있는지역일경우는도는제외하고시부터입력 서울특별시성북구정릉동 서울시성북구정릉동 특별시와광역시를빼고 " 시 " 로입력 충청남도당진군당진읍 충남당진군당진읍 도를줄여서입력 김제시진봉면가실리 김제시진봉면 주소 (ADR)1 에는동 읍 면까지입력하고그외의주소는주소 (ADR)2 에입력

44 원발부위 성별원발부위수정체크사항 1 C519 Vulva, NOS C159 Esophagus, NOS 성별과원발장기명이맞지않는경우 2 C659 Renal pelvis C569 Ovary 성별과원발장기명이맞지않는경우 원발부위수정체크사항 C439 Malignant melanoma of skin D059 Carcinoma in situ of breast C73 Thyroid gland C449 Skin, NOS C509 Breast, NOS C739 Thyroid gland ICD-10 코드로입력한경우 ICD-10 코드로입력한경우 세번째자리까지입력

45 조직학적진단 C421 Bone marrow 원발부위조직학적진단명수정체크 C773 Lymph nodes of axilla or arm C259 Pancreas, NOS 진단방법 Acute lymphoblastic leukemia, NOS Adenocarcinoma, metastatic, NOS Precursor cell lymphoblastic leukemia, NOS Hodgkin lymphoma, nodular sclerosis, grade Adenocarcinoma, NOS 2003 년도등록자료부터는 ICD-O3 코드사용 ICD-O 에없는코드임 원발부위조직학적진단명진단방법수정체크 뇌종양을제외하고 BEHAVIOUR /2 와 /3 만등록 C809 Unknown primary site Adenocarcinoma, NOS 7 6 원발미상일경우는진단방법 7,8 이올수없음 C739 Thyroid gland Papillary carcinoma, NOS Neoplasm, malignant 비현미경적방법에인정하는 23 개코드참조 ( 지침서 P42)

46 SEER STAGING 원발부위조직학적진단명 SEER 수정 C169 Stomach, NOS C739 Thyroid gland Adenocarcinoma, NOS Papillary carcinoma, NOS 치료 : 수술, 화학, 방사선, 면역, 호르몬요법순 치료수정체크 호르몬요법추가입력 치료시행은 1, 시행하지않았으면 0 으로입력

47 성별 & 직업 성별 1 2 직업 13 주부 12 군인 원발부위 & 조직학적진단명 성별원발장기명조직학적진단명수정 1 2 C494 Connective, subcutaneous and other soft tissues of abdomen C632 Scrotum, NOS Endometrioid adenocarcinoma, NOS Seminoma, anaplastic(c62._) Fascial fibrosarcoma C569 Ovary

48 나이 & 원발부위 & 조직학적진단 나이원발부위조직학적진단명수정 2 C779 Lymph node, NOS Hodgkin lymphoma, mixed cellularity, NOS Malignant lymphoma, small B lymphocytic, NOS 8 C649 Kidney, NOS Carcinoid tumor, NOS Renal cell carcinoma, NOS 16 C349 Lung, NOS 50 C589 Placenta Adenocarcinoma, NOS Choriocarcinoma, NOS Squamous cell carcinoma, NOS Choriocarcinoma combined with other germ cell elements 원발부위 & 조직학적행태 원발부위조직학적진단명수정 C419 Bone, NOS C719 Brain, NOS Chondroblastic osteosarcoma(c40._, C41._) Oligodendroblastoma(C71._)

49 중복확인 번호환자명주소초진일원발부위조직학적진단명진단방법사망일치료 SEER 홍길동부천시소사구괴안동 C220 Liver 홍길동부천시소사구괴안동 C221 Intrahepatic bile duct 이춘향서울시성북구정릉동 C508 Overlapping lesion of breast 이춘향서울시성북구정릉동 C209Rectum, NOS Hepatocellular carcinoma, NOS(C22.0) Cholangiocarcinoma(C22.1, C24.0) Infiltrating duct carcinoma, NOS(C50._) Adenocarcinoma, NOS

50 경청해주셔서감사합니다

Very low-risk Low-risk Intermediate-risk High-risk Appendiceal mucinous tumours Mucinous adenoma Mucinou

Very low-risk Low-risk Intermediate-risk High-risk Appendiceal mucinous tumours Mucinous adenoma Mucinou I. Workshop 결과에대한설문조사결과 A. 종양의행태 (behavior) 코드부여에이견이있는소화기계암에대한설문조사결과 Organ or Subject Stomach Colon Diagnosis 응답자수 ( 총 240 명 ) Low grade adenoma/dysplasia 230 10 0 1 2 3 6 무응답 High grade adenoma/dysplasia