影像组学在胃癌诊疗中的应用

胃癌是我国的高发癌种之一,严重危害我国人民的健康。如何基于影像实现定量化、个体化、精准化的辅助诊疗是提高胃癌患者五年生存率的关键之一。近年来人工智能与医学影像的结合催生了影像组学技术,本文从影像组学流程、影像组学在胃癌诊疗中的应用、挑战与机遇三个方面综述胃癌影像组学的研究进展。首先,本文回顾了影像组学的基本流程,包括数据收集和预处理、感兴趣区域分割、特征提取、特征筛选、模型构建、模型评估等步骤。其次,本文概述了影像组学在早期胃癌筛查、胃癌分型分期诊断、胃癌疗效分析与预后预测等方面的应用。最后,本文讨论了胃癌影像组学研究面临的挑战性问题和发展机遇。     

乳腔镜在乳腺疾病治疗中的应用进展

随着腔镜技术在外科领域应用的日趋成熟，乳腔镜下治疗乳腺疾病成为乳腺外科的一大亮点。微创技术和美容外科的完美结合正是乳腔镜下乳腺外科的核心。经过十余年的探索和发展，这一新的技术正在逐步改变着乳腺外科传统的治疗理念，它的成熟可能标志着乳腺外科一个新时代的开始。文章就乳腔镜在乳腺疾病治疗中的应用进展作一综述。     

胃癌外科治疗的新进展及发展趋势

胃癌严重威胁人类健康,尽管近年来化疗、靶向治疗和免疫治疗等新型药物研发不断取得突破,但根治性手术始终是胃癌诊疗的核心。随着标准胃癌根治手术的成型,以腹腔镜技术为代表的微创外科治疗技术的进步,进展期胃癌围手术期综合治疗模式的确定,以及胃癌精准外科理念的形成和初步实践,胃癌手术治疗取得了巨大进步。个体化和精准化胃癌外科治疗理念深入人心。安全、有效、精准、微创始终是胃癌外科医师需牢牢把握的学科发展的内在规律。为帮助年轻医师更好的成长,本文总结胃癌诊疗的最新进展,并对未来的发展趋势进行展望。     

医疗大数据在恶性肿瘤诊治中的应用

随着信息技术的发展和大数据技术的广泛运用,传统的肿瘤诊疗方式已经不能满足医学的需要.医疗大数据的应用深刻地改变了肿瘤诊疗模式,同时也使人们对恶性肿瘤本质有了更深入的认识.医疗大数据统计分析以及管理技术正推动恶性肿瘤诊治从"个体化治疗"时代进入"精准医疗"时代,这使得恶性肿瘤的预测、诊断、治疗以及监测等方面正在发生巨大的变革,同时也面临着各种难题和挑战.     

《肿瘤预防与治疗》文章荐读:妇科肿瘤诊治的几个关系与观念

时代进步,科技发展,医学面临新的机遇和挑战;社会变化,公共需求,医学应对新的任务和改革。妇科肿瘤的基础研究与临床实践,也将面对处理好新的关系和树立好新的观念问题。针对这种局面,郎景和院士在本文中详细探讨了现代科技发展与传统临床医学实践、预防筛查与早诊早治、过度诊断治疗与适宜保守保护、微无创原则与微无创外科、医学人文观念与医学哲学思想等方面的问题,内容深入浅出,引人深思。     

人工智能在甲状腺癌精准化诊疗中的研究进展

甲状腺癌近年来呈高发趋势,需要精确的信息为患者提供高效的个体化服务。人工智能（artificial intelligence,AI）与医学的深度结合有助于提高医疗决策的智能化和精准化。本文结合目前研究主要探讨AI在甲状腺癌精准化诊疗中的研究进展,阐述了AI的概念和发展,以及精准化在甲状腺癌诊治中的意义;重点探讨AI在甲状腺癌诊断和预后预测方面的应用潜力,详细分析了超声、病理学诊断和基于传统病理参数、基因变异通路模型预后评估的机遇和挑战;对未来甲状腺癌AI研究做出展望。本文为应用AI技术进行关键信息的提取以期指导个体化治疗奠定基础。      

智慧科技与创新外科——智慧医疗助推头颈外科发展

智慧医疗作为生命医学和信息科学技术的融合交又产物,为头颈外科的发展带来了机遇和挑战。其中借助远程联络系统为患者提供了新型的远程诊疗模式,数字化外科技术在提高手术准确性的同时最大化地满足了个性化的外科需求,手术机器人依靠多维度精细化等优势能够通过不同于传统手术的人路实现更多复杂疾病的微创精准治疗,人工智能辅助临床诊疗与随访.方便了患者.解放了医护。面对汹通的科持浪潮度卷医疗领域 斗-颈外科医生作为变革时代的"弄潮儿",应该积极了解、掌握、应用和发展智慧科技,在传统外科的基础上勇敢创新。本文就智慧医疗在头颈外科领域的研发与应用作一综述。     

精准医学时代的肺癌外科治疗走向

精准医学是根据每个人从宏观到微观层面的个体差异,制定最为合适的个性化治疗方案。基因组、蛋白组、代谢组等海量生物学数据及大数据分析方法是精准医学模式的精髓。精准医学为人类攻克肿瘤带来了希望。肺癌是对人类危害最大的肿瘤。本文就肺癌的外科治疗在精准医学时代发展的方向进行了综述。     

胃癌外科治疗的热点问题与展望

我国胃癌患者约占全球胃癌患者总数的39.4%,以进展期为主,发病率与死亡率居我国恶性肿瘤前列,目前我国的胃癌诊治条件仍面临着严峻挑战。近年来,随着我国胃癌早期诊断率的升高以及部分高质量的临床研究结果的公布,我国胃癌外科治疗模式也发生一定改变,部分领域达到国际领先地位。全文就早期胃癌的外科治疗、进展期胃癌围手术期治疗、晚期胃癌转化外科治疗、胃癌微创手术等近年外科热点问题进行综述,以期为临床实践过程中制定胃癌患者个体化治疗方案提供参考。     

腹腔镜结直肠手术正向我们阔步走来

今日医学里,病人作为社会人受到更大尊重.谁不希望能保持一个健全、完整、美观的躯体,何况还能少受创痛呢--何乐而不为!"外科微创化"已经成为医患双方共同的追求.历史上因受到当时科技发展和观念上的制约,接受手术的病人常常蒙受极大的苦难.外科医生们为此一直潜心为如何减少患者的痛苦而进行创新的努力,各种腔镜手术(腹腔镜、宫腔镜、胸腔镜和乳腔镜等)以及乳腺癌手术缩小的巨大变革就是其中的典型范例.腔镜外科推动了"外科微创化"的浪潮,但当时尚未能预见到它的发展和影响会如此之大.     

胃癌诊疗的热点和问题

我国是胃癌高发地区,发病率与死亡率在恶性肿瘤中均位居前列,受区域发展水平的制约,我国的胃癌诊治条件尚不能够完全满足众多病患的需求,面临着十分严峻的抗击胃癌形势。多学科、个体化、规范化治疗是胃癌诊治的发展趋势,目前有关胃癌的热点及争议有很多,胃癌诊治问题的解决有赖于循证医学研究的进一步发展。本文从胃癌临床分期、腹腔镜手术技术、早期胃癌的诊治、晚期胃癌转化治疗、食管胃结合部癌的治疗策略、快速康复外科、基础医学转化研究及胃癌临床试验等方面进行综述,系统地概括当前胃癌诊疗的热点和问题,希望能对广大同道起到一定的参考作用。     

胃癌诊疗的热点和问题

我国是胃癌高发地区,发病率与死亡率在恶性肿瘤中均位居前列,受区域发展水平的制约,我国的胃癌诊治条件尚不能够完全满足众多病患的需求,面临着十分严峻的抗击胃癌形势。多学科、个体化、规范化治疗是胃癌诊治的发展趋势,目前有关胃癌的热点及争议有很多,胃癌诊治问题的解决有赖于循证医学研究的进一步发展。本文从胃癌临床分期、腹腔镜手术技术、早期胃癌的诊治、晚期胃癌转化治疗、食管胃结合部癌的治疗策略、快速康复外科、基础医学转化研究及胃癌临床试验等方面进行综述,系统地概括当前胃癌诊疗的热点和问题,希望能对广大同道起到一定的参考作用。      

加速康复外科在腹腔镜膀胱癌根治术围手术期应用的研究进展

随着科学与医疗技术不断的发展与成熟,目前腹腔镜技术已广泛应用于泌尿外科疾病的治疗,如膀胱癌根治术和肾癌根治术等.与传统的开放性手术相比,其在创口的大小、术中的失血量、恢复速度等方面皆展现出了极大的优势.加速康复外科是指多学科、多模式间相互配合的且以循证医学为基础的一种医疗理念,其科学的应用可降低患者心理生理应激、提升康...     

Laparoscopic gastrectomy with lymph node dissection for gastric cancer

Since 1991, laparoscopic surgery has been adopted for the treatment of gastric cancer, and it has been performed worldwide, especially in Japan and Korea. We reviewed the English-language literature to clarify the current status of and problems associated with laparoscopic gastrectomy with lymph node dissection as treatment for gastric cancer. In Japan, early-stage gastric cancer (T1/T2, N0) is considered the only indication for laparoscopic gastrectomy. As yet, there is little high-level evidence based on long-term outcome supporting laparoscopic gastrectomy for cancer, but reports have provided level 3 evidence that the procedure is technically safe, and that it yields better short-term outcomes than open surgery; that is, recovery is faster, hospital stay is shorter, there is less pain, and cosmesis is better. However, investigation into the oncological outcome of laparoscopic gastrectomy as treatment for cancer is lacking. To establish laparoscopic surgery as a standard treatment for gastric cancer, multicenter randomized controlled trials to compare the short- and long-term outcomes of laparoscopic surgery versus open surgery are necessary.     

达芬奇机器人胃癌手术的技术特点与现状

达芬奇机器人手术系统作为新兴人工智能手术系统,开启了智能化微创手术的新时代,近年逐渐应用于临床。在胃癌外科领域目前报道较少,已成为研究的热点。本文就达芬奇机器人胃癌手术的技术特点、应用现状和前景作一介绍。      

直肠癌外科手术的过去、现在和将来

 直肠癌是一种常见的消化道恶性肿瘤。目前直肠癌的治疗方法很多，包括手术、放疗、化疗及靶向治疗等，但根治性手术切除依然是直肠癌治疗的首选方案。直肠癌外科手术的方式经历了萌芽、成熟、注重保护功能、器械改进、理念革新、微创化、多学科诊疗的过程，一直在不断地发展、完善。随着临床医学、临床流行病学、现代信息学、分子生物学、基因组学、组织工程、干细胞技术以及远程通讯、人工智能、激光手术器械、神经定位导航系统等生物工程学的发展，直肠癌手术必将从以往的毁损性切除、修复，进入重建、再生医学的阶段。手术方式的创新也向人性化、个体化、微创化、精准化方向发展，手术方式的发展也只有在满足患者个人生活的更大目标时才具有合理性。     

人工智能在肿瘤放射治疗中的研究进展

大数据和人工智能在各行各业方兴未艾,在精准放疗领域也在不断深入。近些年来,放射治疗技术发展迅速,积累了大量的影像和治疗数据,接下来迫切需要进行大数据分析,来协助医生做决策,提高医生和物理师的工作效率,加强放疗过程的质控,因此人工智能在放疗领域应运而生。本文阐述了人工智能在放射治疗各环节中的发展前景和应用情况。     

Minimally invasive surgery for gastric cancer — toward a confluence of two major streams: a review

The minimalization of therapeutic invasiveness in order to preserve quality of life (QOL) is a major topic in the management of early gastric cancer. After laparoscopic surgery for gastric cancer was introduced by Kitano et al. in 1991, an enthusiasm to develop laparoscopic procedures has grown steadily. In the initial phase, early gastric cancer limited to the mucosal layer with no risk of lymph node metastasis was treated by laparoscopic wedge resection or intragastric mucosal resection. Since technical and instrumental advances in endoscopic treatment were achieved by gastroenterologists, these cases can be managed by intraluminal endoscopic approaches. The attention of surgeons then shifted to more radical procedures such as laparoscopic gastrectomy with lymph node dissection, which is comparable to open surgery and can be indicated even in advanced cancer. Although this paradigm shift has already been realized in the field of colorectal surgery, we must pay attention to the particular biological nature of gastric cancer in terms of the potential of peritoneal dissemination. While early-phase recovery after surgery has been improved by laparoscopic surgery, preservation of late-phase QOL by function-preserving surgery is also essential in this regard; therefore, the sentinel node (SN) concept has been a much-discussed topic in gastric cancer surgery to approach this aspect. Recently, the validity of the SN concept has been demonstrated by a number of single institutional studies, and prospective multicenter trials are currently ongoing. Theoretically, various types of function-preserving surgery could be applied in cases of early gastric cancer with negative SNs as less invasive surgery to improve long-term QOL. Although we still have to solve several remaining issues in the treatment of gastric cancers, a confluence of these two major streams, laparoscopic surgery and sentinel node navigation surgery, would enable us to apply a novel individualized minimally invasive approach, both in terms of degree of incisional access and extent of function preservation.     

Laparoscopic surgery for gastric cancer: Current status and future direction

Gastric cancer is still a major cause of death worldwide. While laparoscopic gastrectomy (LG) has gained evidence as a standard treatment for early gastric cancer in the distal stomach, there are still concerns regarding its application for gastric cancer in the upper stomach and advanced gastric cancer. Nevertheless, LG has shown to have faster recovery, shorter hospital stay, less pain, and less blood loss in many retrospective and prospective studies. The application of LG has now extended from conventional radical gastrectomy to novel approaches such as function-preserving gastrectomy and sentinel-node navigated surgery. Studies on the use of laparoscopy in treatment for stage IV gastric cancer are rare, but show that there may be some roles of LG in selected cases. With the development of new laparoscopic tools that augment human ability, the future of LG should move on from proving non-inferiority to demonstrating superiority compared to the traditional open gastrectomy.     

The advances of laparoscopic treatment for gastric cancer

Recently, laparoscopic surgery for gastric cancer is very interesting topic in the treatment of gastric cancer. Therefore,many surgeons are attempting laparoscopic surgery. However, the technique of this surgery has never been established yet. From July 1997 to July 2006, we performed laparoscopic surgeries for 420 cases of gastric cancer with lymph node dissection. We have describe our technical advances in laparoscopic treatment for gastric cancer along with the clinical outcomes.