Tertiary syphilis,especially in cases involving visceral gummatous disease,can be confused with cancer of the solid organs.We report a case of tertiary hepatic syphilis that manifested with intrahepatic masses in a pa...Tertiary syphilis,especially in cases involving visceral gummatous disease,can be confused with cancer of the solid organs.We report a case of tertiary hepatic syphilis that manifested with intrahepatic masses in a patient who had an underlying primary peritoneal serous carcinoma (PPSC).The patient was diagnosed with PPSC and achieved a complete remission of PPSC following six cycles of platinum-based chemotherapy.Two hepatic nodules developed during the follow-up period and were initially labeled as hepatic metastases from the underlying PPSC,based on radiological findings.A resection of hepatic nodules was performed for therapeutic and diagnostic purposes,because there were no other metastatic foci except in the liver.Unex-pectedly,serology and histology confirmed tertiary sy philis.This rare case emphasizes the importance of including tertiary syphilis in the differential diagnosis of a space-occupying lesion,even with an existing diagn osis of underlying cancer.展开更多
目的比较不同方法检测胃癌患者腹腔游离癌细胞（intraperitoneal free cancer cells,IFCCs）的阳性率．分析不同时点IFCCs的检测结果与胃癌患者短期预后的关系。方法连续纳入2014年7月至2016年3月期间于北京大学人民医院胃肠外科接受手...目的比较不同方法检测胃癌患者腹腔游离癌细胞（intraperitoneal free cancer cells,IFCCs）的阳性率．分析不同时点IFCCs的检测结果与胃癌患者短期预后的关系。方法连续纳入2014年7月至2016年3月期间于北京大学人民医院胃肠外科接受手术的119例胃癌患者，取开腹后即刻、手术操作完成后即刻、冲洗腹腔后3个时间点，分别以300～400ml生理盐水灌洗腹腔并收集灌洗液，进行传统离心法细胞学、滤膜法细胞学、免疫细胞化学以及RT—PCR方法检测IFCCs。采用Kaplan—Meier法绘制胃癌患者生存曲线。结果3个时点传统细胞学法检测IFCCs的阳性率分别为16．8％、20．7％、11．2％，免疫细胞化学法阳性率分别为28．6％、38．8％、20．7％，RT—PCR法阳性率分别为39．3％、69．5％、50．8％。RT—PCR法检测IFCCs的阳性率高于传统细胞学法和免疫细胞化学法（P〈0．05）。开腹后即刻时点．经任一方法检测1FCCs阳性患者的短期预后较阴性患者差（P〈0．05）。手术操作完成后即刻时点，仅传统细胞学法检测IFCCs阳性患者的短期预后较阴性患者差（P〈0．05）。结论IFCCs阳性胃癌患者的短期预后较阴性患者差；胃癌根治性手术切除前为检测IFCCs的最佳时机；手术操作可能增加IFCCs的脱落风险，手术操作完成后腹腔冲洗可减少IFCCs。展开更多
文摘Tertiary syphilis,especially in cases involving visceral gummatous disease,can be confused with cancer of the solid organs.We report a case of tertiary hepatic syphilis that manifested with intrahepatic masses in a patient who had an underlying primary peritoneal serous carcinoma (PPSC).The patient was diagnosed with PPSC and achieved a complete remission of PPSC following six cycles of platinum-based chemotherapy.Two hepatic nodules developed during the follow-up period and were initially labeled as hepatic metastases from the underlying PPSC,based on radiological findings.A resection of hepatic nodules was performed for therapeutic and diagnostic purposes,because there were no other metastatic foci except in the liver.Unex-pectedly,serology and histology confirmed tertiary sy philis.This rare case emphasizes the importance of including tertiary syphilis in the differential diagnosis of a space-occupying lesion,even with an existing diagn osis of underlying cancer.
文摘目的比较不同方法检测胃癌患者腹腔游离癌细胞（intraperitoneal free cancer cells,IFCCs）的阳性率．分析不同时点IFCCs的检测结果与胃癌患者短期预后的关系。方法连续纳入2014年7月至2016年3月期间于北京大学人民医院胃肠外科接受手术的119例胃癌患者，取开腹后即刻、手术操作完成后即刻、冲洗腹腔后3个时间点，分别以300～400ml生理盐水灌洗腹腔并收集灌洗液，进行传统离心法细胞学、滤膜法细胞学、免疫细胞化学以及RT—PCR方法检测IFCCs。采用Kaplan—Meier法绘制胃癌患者生存曲线。结果3个时点传统细胞学法检测IFCCs的阳性率分别为16．8％、20．7％、11．2％，免疫细胞化学法阳性率分别为28．6％、38．8％、20．7％，RT—PCR法阳性率分别为39．3％、69．5％、50．8％。RT—PCR法检测IFCCs的阳性率高于传统细胞学法和免疫细胞化学法（P〈0．05）。开腹后即刻时点．经任一方法检测1FCCs阳性患者的短期预后较阴性患者差（P〈0．05）。手术操作完成后即刻时点，仅传统细胞学法检测IFCCs阳性患者的短期预后较阴性患者差（P〈0．05）。结论IFCCs阳性胃癌患者的短期预后较阴性患者差；胃癌根治性手术切除前为检测IFCCs的最佳时机；手术操作可能增加IFCCs的脱落风险，手术操作完成后腹腔冲洗可减少IFCCs。
