肾肿瘤的超声诊断与病理诊断比较

随着影像学的发展和应用,肾脏肿瘤的确诊率日益提高.将安徽省立医院自1988年1月～1997年5月的肾肿瘤患者的B超诊断与病理诊断做一对照分析,现报告如下. 1 资料和方法 1.1 临床资料 104例肾肿瘤,男66例,女38例,男女之比为1.7∶1,年龄从7个月～81 a,平均年龄为48.1 a.患者多以腰部酸痛,无痛性血尿和腹部包块就诊,部分为健康体检由B超发现肾实质占位而诊断肾肿瘤,多为无症状性肾实质小病灶.其中有腰部酸痛者32例(30.8%),有无痛性血尿者40例(38.5%),有腹部包块者11例(10.6%),有其他症状者4例(3.8%),无症状者17例(16.3%). 1.2 仪器和方法美国Diasonic公司生产的Spectra超声诊断仪,日本东芝SSA-240A,ALOKASSD-620等.探头频率为3.5 MHZ.患者均采用仰卧位及俯卧位等姿势,多体位探查,对可疑病例反复探查.104例中22例做了双肾CT扫描.     

头颈部肿瘤影像学诊断进展

头颈部肿瘤是一种常见的肿瘤,其发病率逐年呈增长趋势,早期临床诊断尤为重要。影像学检查是诊断评价头颈部肿瘤的重要手段,其中CT/MRI灌注检查、PET分子成像等影像学技术是目前研究热点,但各种影像学检查均有其优缺点,多种检查手段的联合应用可以提高头颈部肿瘤诊断的准确度、敏感度和特异度,为临床治疗和预后评估提供重要依据。     

软组织肿瘤穿刺活检的病理诊断及临床应用

目的 探讨软组织肿瘤穿刺活检的病理诊断及临床应用价值.方法 选取2018年6月至2020年6月暨南大学附属第一医院收治的158例软组织肿瘤患者,均于术前行穿刺活检,以术后病理检查结果为金标准,分析穿刺活检诊断软组织肿瘤的价值,评价穿刺活检诊断恶性软组织肿瘤的效能.结果 术后病理检查结果显示,158例软组织肿瘤患者中包括...     

肺转移性肿瘤的临床诊断及外科治疗

评估肺转移性肿瘤的临床诊断及外科治疗情况。78例肺转移瘤手术患者占该院胸心外科同期1127例肺肿瘤手术的6.92%。肺转移性肿瘤患者多无特异性的临床症状,部分可表现为咳嗽、胸痛等。结合病史,临床上常规的检查手段如胸片,CT等可以有效的对肺转移性肿瘤做出诊断。对有手术指征的肺转移性肿瘤患者,应考虑积极的外科手术治疗,外科手术疗效确切。积极的外科手术治疗不仅可以提高患者的生活质量,而且可以阻止肺转移瘤作为传播源进一步向身体其他脏器或组织转移而延长其生命。     

临床与病理诊断符合率对医疗质量评价的影响

临床与病理诊断符合率是反映临床诊断水平的一项重要指标,该指标由医院统计部门根据病案首页信息统计得出。临床与病理诊断符合率的高低关系到医院管理层的评价、关系到科室与医生的自我评价与约束。临床与病理的临床诊断的界定直接关系到临床与病理诊断符合率的高低及其评价意义。随着医院医疗质量管理的发展,     

免疫组化在肿瘤病理诊断中的应用

目的 探讨免疫组化在肿瘤病理诊断中的应用效果,为临床提供参考依据。方法 选取2020年2月—2021年8月蚌埠医学院第一附属医院收治的64例肿瘤患者,随机分为对照组和观察组各32例,对照组采用常规诊断技术,观察组采用免疫组化诊断技术。分析两组阳性检出状况、生理问题评分、心理顾虑评分、信任感评分及诊断满意率。结果观察组诊断阳性率为84.38%,高于对照组的62.50%,差异有统计学意义(χ²=7.849,P<0.05)。观察组生理问题、心理顾虑、信任感评分分别为(90.28±2.96)分、(90.34±3.15)分、(92.47±2.51)分,高于对照组的(83.15±3.15)分、(84.26±2.57)分、(83.15±3.23)分,差异均有统计学意义(P<0.05)。观察组诊断总满意率为93.75%,高于对照组的78.13%,差异有统计学意义(χ²=5.494,P<0.05)。结论 肿瘤病理诊断过程中,与常规穿刺活检技术比较,免疫组化诊断应用价值更高,不仅可以提高肿瘤疾病阳性检出率,而且有助于患者检查舒适度和信任感等提高...     

气管肿瘤的诊断与治疗进展——原发性气管肿瘤的诊断与治疗

原发性气管肿瘤临床较为少见，占支气管起源肿瘤的1％，文献报道占所有上呼吸道肿瘤的1％-2％，多数为恶性，多见于成年人，且诊断困难。文献报道原发性气管癌误诊率高，国内韩俊庆等心报道误诊率达65．9％，平均误诊时间为14个月，Karlan等分析从出现症状到确诊常需10-12个月。[第一段]     

甲状旁腺肿瘤的诊断及外科治疗

目的 探讨甲状旁腺肿瘤的诊断及外科治疗.方法 回顾性分析10例临床资料.结果 10例患者中,腺瘤8例,囊肿2例;5例腺瘤血钙和甲状旁腺素(PTH)均高于正常;其余3例腺瘤及2例囊肿血钙均正常范围.术前予B超和CT检查.10例均手术探查.结论 血钙和PTH测定是可靠的定性诊断方法.B超和CT相结合,必要时结合<'99>T<'m>C-甲氧基异丁基异晴(MIBI)可获得准确的定位诊断.定位明确的单侧肿瘤,结合术中冰冻病理检查和必要时术中快速PTH测定行单侧探查是可行的.     

甲状旁腺肿瘤的诊断及外科治疗

目的 探讨甲状旁腺肿瘤的诊断及外科治疗.方法 回顾性分析10例临床资料.结果 10例患者中,腺瘤8例,囊肿2例;5例腺瘤血钙和甲状旁腺素(PTH)均高于正常;其余3例腺瘤及2例囊肿血钙均正常范围.术前予B超和CT检查.10例均手术探查.结论 血钙和PTH测定是可靠的定性诊断方法.B超和CT相结合,必要时结合<'99>T<'m>C-甲氧基异丁基异晴(MIBI)可获得准确的定位诊断.定位明确的单侧肿瘤,结合术中冰冻病理检查和必要时术中快速PTH测定行单侧探查是可行的.     

甲状旁腺肿瘤的诊断及外科治疗

目的 探讨甲状旁腺肿瘤的诊断及外科治疗.方法 回顾性分析10例临床资料.结果 10例患者中,腺瘤8例,囊肿2例;5例腺瘤血钙和甲状旁腺素(PTH)均高于正常;其余3例腺瘤及2例囊肿血钙均正常范围.术前予B超和CT检查.10例均手术探查.结论 血钙和PTH测定是可靠的定性诊断方法.B超和CT相结合,必要时结合<'99>T<'m>C-甲氧基异丁基异晴(MIBI)可获得准确的定位诊断.定位明确的单侧肿瘤,结合术中冰冻病理检查和必要时术中快速PTH测定行单侧探查是可行的.     

选择性COX-2抑制剂在头颈肿瘤化学预防中的研究进展

近年我国头颈肿瘤发病率呈上升趋势,虽然医疗技术不断发展,但头颈肿瘤的五年生存率并无明显提高.选择性环氧化酶-2(cyclooxygenase-2,COX-2)抑制剂通过抑制前列腺素(prostaglandin,PG)的合成从而抑制肿瘤的发生与发展,是目前肿瘤研究的热点之一.本文旨在对有关选择性COX-2抑制剂的作用机制及其对头颈肿瘤预防效果的动物实验研究进行综述,为在此基础上深入开展临床研究提供借鉴.     

Managing side effects of radiotherapy in head and neck cancer

Curative radiotherapy for head and neck cancer causes very significant side effects. In addition to their considerable impact on the patient's quality of life, these effects can prejudice treatment outcome. This review looks at the management of the adverse effects of radiotherapy for head and neck cancer.     

West of Scotland managed clinical network for head and neck cancer

Background: The Head and Neck Managed Clinical Network (MCN) was established in April 2002 with the aim of ensuring that no matter where a patient receives treatment, their treatment pathway will be the same. An advisory board was set up with representation from the five West of Scotland health board areas (Ayrshire and Arran, Argyll and Clyde, Greater Glasgow, Lanarkshire and Forth Valley). Method: The Advisory Board consists of representatives from the multidisciplinary team including ear, nose and throat, maxillofacial and plastic surgeons, oncologists, radiotherapists, clinical nurse specialists, dietitians, speech and language therapists, palliative care consultant and a patient representative. The dietetic representative on the Advisory Board acts as a link to the 12 members of the Dietetic Subgroup. These dietitians are from across the West of Scotland health boards and local multidisciplinary teams and include both the primary and acute sector. A network manager was appointed in April 2003 and works within a team for the West of Scotland Cancer MCN's, which provide administration, audit, information, statistical and information technology, support to the network. Audit: The network is committed in improving the quality of care and outcomes for patients with head and neck cancers. Agreement of the head and neck minimum dataset across Scotland has still to be achieved. Teleconferencing and clinical meetings: The network has utilized telemedicine conferences to audit new complicated cases throughout the West of Scotland. Monthly meetings link surgeons, oncologists, radiotherapists, pathologist, dietitians, speech and language therapists and clinical nurse specialists in Glasgow, Ayrshire, Forth Valley, Argyll and Clyde and Lanarkshire to provide discussion and agreement in best patient care. Publications: Patient information booklets are being developed to cover all areas of head and neck cancer. Dietitians have been involved in writing the dietetic component of the booklets and also in proof reading the booklets as a whole. Dietitians within this group have been working with the Scottish Nutrition and Diet Resources Initiative to develop a cancer diet information pack entitled ‘A Helping Hand’, which was published in February 2004. Patient pathways: The MCN has been monitoring patient pathways, which are often complex in head and neck cancer patients. Conclusion: Over time with the network, we envisage a powerful multidisciplinary group, which focuses on strategic planning of patient care, to assist delivery of service improvement and clinical benefit. To help achieve this goal, dietitians are sharing information on best practice and producing guidelines.     

Neighborhood deprivation and clinical outcomes among head and neck cancer patients

The unique effects of neighborhood-level economic deprivation on survival, recurrence, and second primary malignancy development were examined using adjusted Cox proportional hazards regression models among 1151 incident squamous cell carcinomas of the head and neck patients. Cancer site was examined as a potential moderator. Main analyses yielded null results; however, interaction analyses indicated poorer overall survival [HR=1.59 (1.00-2.53)] and greater second primary malignancy development [HR=2.99 (1.46-6.11)] among oropharyngeal cancer patients from highly deprived neighborhoods relative to less deprived neighborhoods. Results suggest a dual focus on individual and neighborhood risk factors could help improve clinical outcomes among oropharyngeal cancer patients.     

Radiation related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy

Although 50-70% of head and neck cancer patients in India receive radiotherapy (RT), radiation-related acute and late morbidities and their impact on quality of life (QOL) are infrequently reported. Acute and late radiation morbidities and QOL were assessed in a prospective longitudinal study of 45 patients with head and neck cancers receiving radical RT to a dose of 7000 cGy in conventional fractionation. Grade II acute morbidities experienced by the largest percent of the sample during the course of RT pertained to the mucosa (66.4%), salivary gland (84%), and oesophagus (53%). These morbidities led to an increase in the symptom scores of appetite loss (76.46), fatigue (65.75) and pain (44.77). This increase in the symptom scores consequently led to a significant decline in physical, social and emotional functioning as well as global health status score during the course of RT (p < 0.001). Scores improved after 1 month of RT but did not reach the pre-RT value. Future studies may consider correlating QOL assessment to significant patient and disease related parameters such as performance status, weight loss, stage and site of disease.     

Nutrition management for head and neck cancer patients improves clinical outcome and survival

Up to 80% of patients with head and neck cancers are malnourished because of their lifestyle and the risk factors associated with this disease. Unfortunately, nutrition management systems are not implemented in most head and neck cancer clinics. Even worse, many head and neck surgeons as well as hospital management authorities disregard the importance of nutrition management in head and neck cancer patients. In addition, the often extensive resection and reconstruction required for tumors in the upper aerodigestive tract pose special challenges for swallowing and sufficient food intake, placing special demands on nutrition management. This article presents the basics of perioperative metabolism and nutrition management of head and neck cancer patients and makes recommendations for clinical practice. Implementing a nutrition management system in head and neck cancer clinics will improve the clinical outcome and the survival of the patients.     

Economic burden of head and neck cancer

This literature review presents the economics of head and neck cancer (HNC), the world's sixth most common neoplasm. HNC economics is complicated by the involvement of multiple body sites, multiple medical specialties, and multiple treatment modalities. Economic analyses of HNC published in English between 1990 and 2002 were identified from electronic data sources. Additional studies were identified manually from bibliographies of retrieved articles. Study characteristics and findings were analyzed. We identified 51 studies that reported original cost data. Most were cost-identification or cost-comparison studies; only one evaluated cost-effectiveness. Few assessed the overall economic burden of HNC or cost effectiveness of current treatments, thus making appropriate comparisons impossible. Systematic measurement of the cost of HNC and its treatment in existing practice settings would be valuable. Inclusion of economic components in clinical trials and the conduct of retrospective or prospective observational studies, such as patient registries, would yield important new information.     

头颈部肿瘤患者放射治疗期间营养状况综合评价

目的构建营养评价综合模型,评价头颈部肿瘤患者放疗期间营养状况。方法用SPSS 17.0软件,根据患者营养状况建立综合评价模型。经因子分析确定了4个公因子F1、F2、F3、F4。结果建立的综合评价模型为：F=0.485F1＋0.236F2＋0.164F3＋0.115F4。将患者综合评分按四分位数分为4类：正常、轻度、中度、重度营养不良。结论利用因子分析得到的营养综合评价模型,能更全面反映患者营养状况,有利于早期发现营养不良,及时给予营养干预。