论文部分内容阅读
一、诊断日本对肝细胞癌诊断水平的提高是惊人的。目前,医学界关心的是如何确切地诊断2厘米以下的癌结节。虽然超声诊断(US)已普遍用于筛选检查,但因诊断2厘米以下的癌结节还存在不少困难,所以发明了将少量的CO_2注入肝动脉或门静脉后,再用US查找癌结节的办法。或可在US 诱导下,进行吸引细胞诊断和组织诊断。核磁共振法(MRI)对肝细胞癌的诊断效果与CT大致相同,并且,在肝细胞癌和肝海绵状血管瘤的鉴别方面,Ca-DTPA 静注后的动态MRI的诊断效果与碘剂注射后的动态CT 也大致相同。另一方面,关于发生肝细胞癌的高危险群的诊断,在所谓小肝细胞癌时AFP 的阳性率不高,这样,作为筛选检查项目就有限度。而当血液中出现异常的凝血酶原(PIVKA-Ⅱ)时,对肝细胞癌就有较高的特异性,并且,与AFP 无关,所以,筛选检查是有希望的。二、治疗主要用于对不能切除的病例实行的肝动脉栓塞术(TAE),栓塞物质是阿霉素、碘化罂粟油造影剂、明胶海绵、大量的罂粟油造影剂、微胶囊化丝裂霉素等,这些方法分别取得了良好的效果。另一方面,把
First, the diagnosis of Japanese diagnosis of hepatocellular carcinoma is an astonishing improvement. At present, the medical community is concerned with the exact diagnosis of cancer nodules below 2 cm. Although ultrasonography (US) has been widely used in screening tests, there are still many difficulties in diagnosing cancer nodules below 2 cm, so inventing a small amount of CO 2 injection into the hepatic artery or portal vein, and then finding the cancer nodules with US The way. Or can be induced by US, to attract cell diagnosis and tissue diagnosis. The diagnostic effect of magnetic resonance imaging (MRI) on hepatocellular carcinoma is approximately the same as that of CT. Moreover, in the differential diagnosis of hepatocellular carcinoma and hepatic cavernous hemangioma, the diagnostic effect of dynamic MRI after Ca-DTPA intravenous injection and iodine injection After the dynamic CT is also about the same. On the other hand, regarding the diagnosis of a high-risk group that develops hepatocellular carcinoma, the positive rate of AFP in so-called small hepatocellular carcinoma is not high, so there is a limit as a screening test item. When abnormal thrombin (PIVKA-II) occurs in the blood, it has high specificity for hepatocellular carcinoma and is not associated with AFP. Therefore, screening tests are promising. Second, the treatment is mainly used for unresectable cases of hepatic artery embolization (TAE), embolus substances are doxorubicin, iodized poppy oil contrast agent, gelatin sponge, a lot of poppy oil contrast agent, microencapsulated mitosis These methods have achieved good results, respectively. On the other hand,