《WHO女性生殖器官肿瘤学分类（第4版）》[1]（WHO Classification of Tumours of Female Reproductive Organs）终于出版了,距《WHO乳腺和女性生殖器官肿瘤病理学和遗传学分类》[2]的出版已经10年余.在此期间,女性生殖系统肿瘤病理领...《WHO女性生殖器官肿瘤学分类（第4版）》[1]（WHO Classification of Tumours of Female Reproductive Organs）终于出版了,距《WHO乳腺和女性生殖器官肿瘤病理学和遗传学分类》[2]的出版已经10年余.在此期间,女性生殖系统肿瘤病理领域出现了诸多进展,对一些疾病的认识有了进一步提高,同时对另一些疾病的性质、命名等仍存在许多争议.本书的出版期望对近十余年来妇科病理领域的学术进展进行了有效梳理,根据现有认识及循证医学证据,对有争议的问题进行了阶段性的厘清.展开更多
Management of rectal cancer has evolved over the years. In this condition preoperative investigations assist in deciding the optimal treatment. The relation of the tumor edge to the circumferential margin (CRM) is an ...Management of rectal cancer has evolved over the years. In this condition preoperative investigations assist in deciding the optimal treatment. The relation of the tumor edge to the circumferential margin (CRM) is an important factor in deciding the need for neoadjuvant treatment and determines the prognosis. Those with threatened or involved margins are offered long course chemoradiation to enable R0 surgical resection. Endoanal ultrasound (EUS) is useful for tumor (T) staging; hence EUS is a useful imaging modality for early rectal cancer. Magnetic resonance imaging (MRI) is useful for assessing the mesorectum and the mesorectal fascia which has useful prognostic significance and for early identification of local recurrence. Computerized tomography (CT) of the chest, abdomen and pelvis is used to rule out distant metastasis. Identification of the malignant nodes using EUS, CT and MRI is based on the size, morphology and internal characteristics but has drawbacks. Most of the common imaging techniques are suboptimal for imaging following chemoradiation as they struggle to differentiate fibrotic changes and tumor. In this situation, EUS and MRI may provide complementary information to decide further treatment. Functional imaging using positron emission tomography (PET) is useful, particularly PET/CT fusion scans to identify areas of the functionally hot spots. In the current state, imaging has enabled the multidisciplinary team of surgeons, oncologists, radiologists and pathologists to decide on the patient centered management of rectal cancer. In future, functional imaging may play an active role in identifying patients with lymph node metastasis and those with residual and recurrent disease following neoadjuvant chemoradiotherapy.展开更多
文摘《WHO女性生殖器官肿瘤学分类（第4版）》[1]（WHO Classification of Tumours of Female Reproductive Organs）终于出版了,距《WHO乳腺和女性生殖器官肿瘤病理学和遗传学分类》[2]的出版已经10年余.在此期间,女性生殖系统肿瘤病理领域出现了诸多进展,对一些疾病的认识有了进一步提高,同时对另一些疾病的性质、命名等仍存在许多争议.本书的出版期望对近十余年来妇科病理领域的学术进展进行了有效梳理,根据现有认识及循证医学证据,对有争议的问题进行了阶段性的厘清.
文摘Management of rectal cancer has evolved over the years. In this condition preoperative investigations assist in deciding the optimal treatment. The relation of the tumor edge to the circumferential margin (CRM) is an important factor in deciding the need for neoadjuvant treatment and determines the prognosis. Those with threatened or involved margins are offered long course chemoradiation to enable R0 surgical resection. Endoanal ultrasound (EUS) is useful for tumor (T) staging; hence EUS is a useful imaging modality for early rectal cancer. Magnetic resonance imaging (MRI) is useful for assessing the mesorectum and the mesorectal fascia which has useful prognostic significance and for early identification of local recurrence. Computerized tomography (CT) of the chest, abdomen and pelvis is used to rule out distant metastasis. Identification of the malignant nodes using EUS, CT and MRI is based on the size, morphology and internal characteristics but has drawbacks. Most of the common imaging techniques are suboptimal for imaging following chemoradiation as they struggle to differentiate fibrotic changes and tumor. In this situation, EUS and MRI may provide complementary information to decide further treatment. Functional imaging using positron emission tomography (PET) is useful, particularly PET/CT fusion scans to identify areas of the functionally hot spots. In the current state, imaging has enabled the multidisciplinary team of surgeons, oncologists, radiologists and pathologists to decide on the patient centered management of rectal cancer. In future, functional imaging may play an active role in identifying patients with lymph node metastasis and those with residual and recurrent disease following neoadjuvant chemoradiotherapy.
