鼻咽癌的内镜诊断及鉴别诊断

纤维鼻咽镜检查下对鼻咽肿块进行病理组织活检是目前确诊鼻咽癌的标准手段,同时,纤维鼻咽镜对鼻咽癌的早期诊断及鉴别诊断以及其他鼻咽、鼻疾病的诊断均有较高的价值.全文就纤维鼻咽镜的操作、活检方式及对鼻咽癌诊断的意义、鉴别诊断作一综述.     

The Diagnosis and Differential Diagnosis of Ureteral Fibroepithelial Polyps

OBJECTIVE To study the clinical pathologic characteristics and differential diagnosis of ureteral fibroepithelial polyps. METHODS One case of ureteral fibroepithelial polyps was studied by clinical data analysis and light microscopy. RESULTS The tumor was located in the lower ureter. Histologically, the polyp was composed of expanded blood vessels and fibrous connective tissue under normal or proliferous transitional epithelium. CONCLUSION Benign ureteral fibroepithelial polyps are extremely rare, recognition of it's precise histological features can facilitate its correct diagnosis.     

超声内镜对消化道早期癌的诊断价值

目的：探讨超声内镜对消化道早期癌的临床诊断价值。方法对90例消化道早期癌患者的内镜检查及临床资料进行回顾性分析,以术后病理诊断为标准,探讨超声内镜对消化道肿瘤的临床早期诊断及分型诊断价值。结果超声内镜检查对食管癌、胃癌和结直肠癌的临床诊断的准确率为85．3％、88．9％、86．2％,均明显高于常规内镜检查结果。超声内镜对早期食管癌分型结果与术后病理学检查证实的符合率为85．3％（29／34）;其对早期胃癌的分型诊断结果表明早期胃癌以浅凹陷（Ⅱc）为主（40．7％）,浸润深度以黏膜内癌为主（63．0％）,组织学以低分化腺癌较多（74．1％）;与病理学分期诊断比较,超声内镜对29例早期结直肠癌患者的诊断准确为72．4％（21／29）。结论超声内镜对消化道早期癌的诊断价值较高,对其临床指导治疗具有重要的意义,值得进一步推广和应用。     

肝胆管细胞癌的CT诊断

目的　提高肝胆管细胞癌的CT诊断准确率。方法　收集病理证实的 3 4例肝胆管细胞癌的CT平扫及增强资料。结果　 3 4例肝胆管细胞癌平扫呈大片不均匀低密度灶 ,19例其内可见圆形或树枝状更低密度影 ;18例可见高密度钙化影 ;2 1例邻近肝内胆管扩张 ;11例肿瘤同侧肝萎缩。 3 4例增强肝胆管细胞癌均扫描表现为延迟持续强化。结论　肝胆管细胞癌具有特征性CT表现。     

细针吸取细胞学对甲状腺肿瘤的诊断与鉴别诊断

本文通过甲状腺肿瘤细针吸取细胞学涂片观察和结合文献，对甲状腺癌细胞中出现的某些特征：核内包涵体、核沟细胞、毛玻璃样核、乳头状结核作了详细的描述。研究显示：核内包涵体在乳头状癌中多见，可作为诊断乳头状癌的重要指标；核沟细胞在滤泡癌和乳头状癌中均可见到，但数量少，对诊断癌有一定价值；甲状腺癌细胞中罕见上述癌之特征。研究还发现，甲状腺癌细胞核普遍增大至１０～１２μｍ以上，并具备其它恶性指征。文章对甲状腺良恶性肿瘤细胞诊断和鉴别亦作了概括。     

Diagnosis of fungal infections

Summary. Fungal infections become more and more important due to their increasing incidence in immunocompromised patients. In these patients opportunistic fungi (Candida, Aspergillus, Cryptococcus) can cause life-threatening infections. Diagnosis of fungal infections is difficult. Clinical symptoms are uncharacteristic, and laboratory diagnosis is confronted with many problems and requires expert interpretation.
Zusammenfassung. Pilzinfektionen nehmen in ihrer Bedeutung zu wegen der steigenden Häufigkeit bei infektabwehrgeschwächten Patienten. Bei diesen können opportunistische Pilze (Candida, Aspergtllus, Cryptococcus) lebensbcdrohliche Infektionen verursachen. Die Diagnose der Pilzinfektionen ist schwierig: Die klinischen Symptome sind uncharakteristisch und die Labordiagnose ist problematisch und erfordert sachkundige Interpretation.     

Quality in Cancer Diagnosis

Improving the quality of oncologic pathology diagnosis is immensely important as the overwhelming majority of the approximately 1.6 million patients who will be diagnosed with cancer in 2010 have their diagnoses established through the pathologic interpretation of a tissue sample. Millions more patients have tissue samples obtained to rule out cancer and do not have cancer. The majority of studies on the quality of oncologic pathology diagnoses have focused on patient safety and have documented a variety of causes of error that occur in the clinical and pathology laboratory testing phases of diagnostic testing. The reported frequency of a diagnostic error made by oncologic pathology depends on several factors, such as definitions and detection methods, and ranges from 1% to 15%. The large majority of diagnostic errors do not result in severe harm, although mild to moderate harm in the form of additional testing or diagnostic delays occurs in up to 50% of errors. Clinical practitioners play an essential role in error reduction through several avenues such as effective test ordering, providing accurate and pertinent clinical information, procuring high‐quality specimens, providing timely follow‐up on test results, effectively communicating on potentially discrepant diagnoses, and advocating second opinions on the pathology diagnosis in specific situations. CA Cancer J Clin 2010;60:139–165. © 2010 American Cancer Society, Inc.     

Diagnosis of bladder cancer

Increasing incidence of bladder tumors necessitates development of new techniques of early diagnosis. A total clinical system including application of ultrasonoangiography proved superior to examination under the gray scale mode. The diagnostic and monitoring algorithm makes the system highly effective.     

乳腺钼靶片的计算机辅助诊断

全文综述了乳腺钼靶片的计算机辅助诊断的基本过程及临床应用。并对其发展趋势进行了展望。     

Diagnosis: tumor marker

We have reviewed the clinical usefulness of tumor markers in gynecologic malignancy. In cervical squamous cell carcinoma. SCC and CEA showed increase in frequency of elevated cases according to the clinical stages (FIGO), and the frequency was significantly higher in recurrent cases than in patients with no evidence of disease. In endometrial carcinoma, presently, no specific tumor marker has been found. The diagnostic efficiency of CA 125, CA 19-9 and TPA were 25.2, 23.8 and 32.6, respectively. Further investigation must be necessary to establish markers sensitive enough. In primary ovarian malignancy, combination assay might be much more useful than single assay. The most effective combinations were TPA/CA 125/Ferritin in serous cystadenocarcinoma, and CEA/CA 19-9/TPA in mucinous cystadenocarcinoma. In the monitoring of the disease, it seems to be essential to select suitable combination of markers in each case. In addition, recently, multivariate analysis systems, such as CAMPAS (computer-aided multivariate and pattern analysis system), have become available.     

纵观乳腺癌的诊断

 乳腺癌的早期诊断对提高乳腺癌患者的生存率，改善其预后具有极其重要的意义，近年来乳腺癌早期诊断的水平有了很大提高，但仍有一定的局限性。就乳腺癌诊断的现状、发展、趋势及热点问题进行阐述