Hepatocellular carcinoma(HCC) is ranked as the 5th common type of cancer worldwide and is considered as the 3rd common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosisis de...Hepatocellular carcinoma(HCC) is ranked as the 5th common type of cancer worldwide and is considered as the 3rd common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosisis determined by several factors; tumour extension, alpha-fetoprotein(AFP) concentration, histologic subtype of the tumour, degree of liver dysfunction, and the patient's performance status. HCC prognosis is strongly correlated with diagnostic delay. To date, no ideal screening modality has been developed. Analysis of recent studies showed that AFP assessment lacks adequate sensitivity and specificity for effective surveillance and diagnosis. Many tumour markers have been tested in clinical trials without progressing to routine use in clinical practice. Thus, surveillance is still based on ultrasound(US) examination every 6 mo. Imaging studies for diagnosis of HCC can fall into one of two main categories: routine non-invasive studies such as US, computed tomography(CT), and magnetic resonance imaging, and more specialized invasive techniques including CT during hepatic arteriography and CT arterial portography in addition to the conventional hepatic angiography. This article provides an overview and spotlight on the different diagnostic modalities and treatment options of HCC.展开更多
目的比较低温等离子射频消融术与CO2激光治疗早期声门型喉癌的临床疗效。方法选取2007年10月~2012年12月行手术治疗的104例早期声门型喉癌（Tis、T1a、T1b）患者,其中64例行低温等离子射频消融术（等离子组）,40例行CO2激光切除术（CO2...目的比较低温等离子射频消融术与CO2激光治疗早期声门型喉癌的临床疗效。方法选取2007年10月~2012年12月行手术治疗的104例早期声门型喉癌（Tis、T1a、T1b）患者,其中64例行低温等离子射频消融术（等离子组）,40例行CO2激光切除术（CO2激光组）。记录并比较两组手术时间、术后第二日疼痛程度[视觉模拟评分法（visual analog scale,VAS）]评分;所有患者于术后一周、1个月及3个月行电子喉镜及嗓音声学分析,并进行随访观察。结果等离子组平均手术时间为8.75±1.62min,CO2激光组平均手术时间为11.82±1.51min,等离子组优于CO2激光组（P〈0.05）。术后第二日VAS评分等离子组（2.79±0.47分）与CO2激光组（2.96±0.64分）组间差异无统计学意义（P〉0.05）。等离子组术后1个月粘膜恢复情况好于CO2激光组（χ2=13.842,P〈0.05）。单因素重复测量分析结果显示：等离子组及CO2激光组术后嗓音声学指标jitter、shimmer、HNR随术后时间延长逐渐好转,在术后3个时间点的变化差异有统计学意义（P〈0.05）,且呈线性变化趋势。多因素重复测量方差分析结果显示：嗓音声学指标（jitter、shimmer、HNR）在术后3个时间点两组间差异均有统计学意义（P〈0.05）。等离子组与CO2激光组术后3年生存率、局部复发率、侵及前联合复发率、前联合术后粘连率组间差异均无统计学意义（P〉0.05）。两组所有患者均未行气管切开术,术后无呛咳,无呼吸困难,无严重疼痛及咯血等严重并发症。结论低温等离子射频消融术与CO2激光治疗早期声门型喉癌均较安全、有效,而低温等离子射频消融术手术时间较CO2激光手术短,术后一月粘膜恢复及嗓音恢复均优于CO2激光手术。展开更多
文摘Hepatocellular carcinoma(HCC) is ranked as the 5th common type of cancer worldwide and is considered as the 3rd common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosisis determined by several factors; tumour extension, alpha-fetoprotein(AFP) concentration, histologic subtype of the tumour, degree of liver dysfunction, and the patient's performance status. HCC prognosis is strongly correlated with diagnostic delay. To date, no ideal screening modality has been developed. Analysis of recent studies showed that AFP assessment lacks adequate sensitivity and specificity for effective surveillance and diagnosis. Many tumour markers have been tested in clinical trials without progressing to routine use in clinical practice. Thus, surveillance is still based on ultrasound(US) examination every 6 mo. Imaging studies for diagnosis of HCC can fall into one of two main categories: routine non-invasive studies such as US, computed tomography(CT), and magnetic resonance imaging, and more specialized invasive techniques including CT during hepatic arteriography and CT arterial portography in addition to the conventional hepatic angiography. This article provides an overview and spotlight on the different diagnostic modalities and treatment options of HCC.
文摘目的比较低温等离子射频消融术与CO2激光治疗早期声门型喉癌的临床疗效。方法选取2007年10月~2012年12月行手术治疗的104例早期声门型喉癌（Tis、T1a、T1b）患者,其中64例行低温等离子射频消融术（等离子组）,40例行CO2激光切除术（CO2激光组）。记录并比较两组手术时间、术后第二日疼痛程度[视觉模拟评分法（visual analog scale,VAS）]评分;所有患者于术后一周、1个月及3个月行电子喉镜及嗓音声学分析,并进行随访观察。结果等离子组平均手术时间为8.75±1.62min,CO2激光组平均手术时间为11.82±1.51min,等离子组优于CO2激光组（P〈0.05）。术后第二日VAS评分等离子组（2.79±0.47分）与CO2激光组（2.96±0.64分）组间差异无统计学意义（P〉0.05）。等离子组术后1个月粘膜恢复情况好于CO2激光组（χ2=13.842,P〈0.05）。单因素重复测量分析结果显示：等离子组及CO2激光组术后嗓音声学指标jitter、shimmer、HNR随术后时间延长逐渐好转,在术后3个时间点的变化差异有统计学意义（P〈0.05）,且呈线性变化趋势。多因素重复测量方差分析结果显示：嗓音声学指标（jitter、shimmer、HNR）在术后3个时间点两组间差异均有统计学意义（P〈0.05）。等离子组与CO2激光组术后3年生存率、局部复发率、侵及前联合复发率、前联合术后粘连率组间差异均无统计学意义（P〉0.05）。两组所有患者均未行气管切开术,术后无呛咳,无呼吸困难,无严重疼痛及咯血等严重并发症。结论低温等离子射频消融术与CO2激光治疗早期声门型喉癌均较安全、有效,而低温等离子射频消融术手术时间较CO2激光手术短,术后一月粘膜恢复及嗓音恢复均优于CO2激光手术。
