“医å¦è‹±è¯ï¼šè¡¨è¾¾æœ‰å…³ç™Œç—‡çš„英è¯å¦ä¹ 情景â€�相信是准备å¦ä¹ 医å¦è‹±è¯çš„æœ‹å�‹æ¯”较关注的事情,为æ¤ï¼ŒåŒ»å¦æ•™è‚²ç½‘å°�ç¼–æ•´ç�†å†…容如下:
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General evaluation.The diagnosis of cancer can be simple or it can challenge all the skills of clinical investigation.
æ™®é��诊æ–。癌症的诊æ–å�¯é�žå¸¸å®¹æ˜“,也å�¯æŒ‘æˆ˜ä¸´åºŠç ”ç©¶çš„æ‰€æœ‰æŠ€èƒ½ã€‚
In some instances metastatic tumors may be the first indication of cancer,and the primary lesion may escape efforts at detection.
有时转移癌�能是癌症的第一指�,而原��害�难以�现。
The challenge is to detect cancer as early as possible,when it is most likely to be cured.
我们所é�¢ä¸´çš„æŒ‘战是尽早å�‘现癌症,尽早å�‘çŽ°å¢žåŠ æ²»æ„ˆå�¯èƒ½ã€‚
One third of new patients have in situ or localized cancer,one quarter have regional lymph node disease,
在所有新病人ä¸ï¼Œä¸‰åˆ†ä¹‹ä¸€æ˜¯åŽŸä½�癌,四分之一患局部淋巴结疾病,
and one third have distant diseaseï¼›the remaining few per cent have disease of undefined stage.
三分之一有转移性疾病,少数病患的病情阶段尚未明确。
Early detection of localized disease is aided by an awareness of risk factors in the family history,personal habits(tobacco,alcohol,sun exposure)and occupational exposure(asbestos,chromium,benzene)。
为尽早å�‘现原ä½�癌,我们è¦�通过家æ—�å�²ã€�ä¸ªäººä¹ æƒ¯ï¼ˆæŠ½çƒŸã€�饮酒ã€�光照)以å�Šè�Œä¸šæ€§ç…§å°„(石绵ã€�铬ã€�苯)的å�±é™©ç³»æ•°æ�¥æ‰¶åŠ©æ£€æµ‹ã€‚
It also requires attention to subtle and nonspecific symptoms of fatigue,weakness,weight loss,depression,headache,pain,changes in bowel habits,
还�注�疲劳�虚弱����抑��头疼�疼痛�排便�
persistent cough or hoarseness,rectal bleeding,and other clues from the history.
æŒ�ç»å’³å—½ã€�声音嘶哑ã€�ç›´è‚ å‡ºè¡€ã€�å®¶æ—�å�²ç‰ç»†å¾®æˆ–é�žç‰¹å®šç—‡çŠ¶ã€‚
In evaluating a patient who presents with nonspecific symptoms that might be indicators of malignancy,such as weight loss,fever,or fatigue,
åœ¨è¯Šæ–æœ‰é�žç‰¹å®šç—‡çŠ¶çš„ç—…æ‚£æ—¶ï¼Œä¾‹å¦‚å‡�é‡�ã€�高烧或疲劳,这些或是æ�¶æ€§è‚¿ç˜¤çš„æ ‡å¿—,
the physician should carefully examine all mucosal surfaces,the sigmoid colon,and the rectum for masses or ulcerated lesions.
医生è¦�细心检测所有粘膜表é�¢ã€�ä¹™çŠ¶ç»“è‚ ï¼Œç›´è‚ è‚¿å�—或溃疡性病å�˜ã€‚
In addition to elements of a routine examination,stool should be tested for occult blood.
除了常规检测,粪便�进行�血试验。
More subtle clues may be seen in the skin with finding such as petechiae,hyper-pigmentation of skin folds(acanthosis nigricans),or atypical moles(dysplastic nevi)。
我们还�以在皮肤上�现细微�兆,例如淤点�皮皱深度过度(黑棘皮症)或是�典型痣(�育�良性痣)
Attention should be paid to the presence of systemic cancer-associated effects,such as neuromyopathies.
�对出现的全身性癌症病症给予关注,比如神�肌病。
Leads from laboratory testing may be found in unexplained anemia,thrombocytopenia,hypercalcemia,or elevation of serum LDH and acid or alkaline phosphatase levels.
实验室检测æ��示ä¸�æ˜ŽåŽŸå› çš„è´«è¡€ï¼Œè¡€å°�æ�¿å‡�少,高钙血症以å�Šè¡€æ¸…乳酸脱氢酶ã€�酸性磷酸酶和碱性磷酸酶水平的å�‡é«˜ã€‚
Other frequent harbingers of cancer are pulmonary nodules or radiolucent bone lesions associated with new bone pain.
其它常�先兆有肺结节,以�与新骨痛有关的��性骨病。
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As a pathologic entity,cancer is defined by its properties of uncontrolled local proliferation of cells,
作为病ç�†å¦å®žä½“,癌症指的是细胞æ�¶æ€§ç¹�殖,且ä¸�å�¯æŽ§ï¼Œ
with invasion of adjacent normal structure and by distant spread,or metastasis,via the bloodstream of lymphatic or within a body cavity.
å¹¶ç ´å��周边æ£å¸¸ç»†èƒžç»„织,通过淋巴系统或在体腔内完æˆ�转移。
As a biologic entity,the malignant cell is defined by its ability to grow in tissue culture without the need for attachment to a firm surface
作为生物体,肿瘤细胞的æ�¶æ€§æ€§è´¨æ˜¯ç”±ä¸‹é�¢å› ç´ å†³å®šçš„ï¼šåœ¨ç»„ç»‡åŸ¹å…»æ—¶ï¼Œå®ƒæ— éœ€é™„ç�€äºŽå�šå›ºçš„表é�¢å°±èƒ½ç”Ÿé•¿ï¼Œ
and by its loss of responsiveness to growth regulatory signals that cause differentiation and suppress proliferation.
并且它对能够引起分化和抑制增生的生长调节信�没有�应。
Many malignant cells preserve the growth and antigenic properties characteristic of fetal cells,
许多肿瘤细胞会继ç»å¢žé•¿ï¼Œä»¥å�Šå…·æœ‰æŠ—原性的癌胚细胞,
secrete proteins characteristic of fetal tissues(such as the a-fetoprotein of hepatocellular carcinomas and germ-cell tissues),
还�分泌具有癌胚组织特性的蛋白质(例如�癌细胞的甲胎蛋白和生殖细胞组织),
and appear to be frozen in an early state of differentiation that recapitulates a specific stage in normal organ development.
在æ£å¸¸å™¨å®˜ç”Ÿé•¿çš„特殊阶段-分化,癌细胞处于冷冻状æ€�。
For example,malignancies arising from the lymphoid system reflect all stages and types of B-and T-lymphocyte development and preserve the same complex of immunoglobulin
ä¾‹å¦‚ï¼Œæ·‹å·´ç³»ç»Ÿä¸æ�¶æ€§è‚¿ç˜¤ä¼šä½“现在所有阶段,T淋巴细胞和B淋巴细胞的å�‘展也å�Œæ ·å¦‚æ¤ï¼Œå®ƒä¿�留了å…�ç–«ç�ƒè›‹ç™½çš„å¤�æ�‚性,
and T-cell receptor gene rearrangement and cell surface proteins(and in some cases potential for future differentiation)found in normal counterparts of the immune system.
T细胞å�—ä½“åŸºå› é‡�排以å�Šç»†èƒžè¡¨é�¢è›‹ç™½è´¨ï¼ˆåœ¨è®¸å¤šæƒ…况下,这些细胞会继ç»åˆ†åŒ–),我们å�¯ä»¥åœ¨æ£å¸¸çš„å…�疫系统ä¸å�‘现。
These properties have become the basis for classification,diagnosis,and even treatment of tumors,
这些特性是进行分类ã€�诊æ–甚至是治疗的基础,
as,for example,classification of lymphoid tumors based on reactivity with monoclonal antibodies.
ä¾‹å¦‚æ ¹æ�®å�•克隆抗体为基础的淋巴细胞分类。
While the above characteristics are typical of most cancer cells,they are not universal.
上述特性适用于多数癌细胞,但它们�是普�的。
Some endocrine-related tumors,for example,not only maintain well-differentiated morphologic features of their tissue of origin
例如一些内分泌相关肿瘤,它们在形�上就维�了组织�期的良好分化,
but also retain endocrine function and produce bioactive hormonal substances typical of the mature tissue,as in pheochromocy-tomas.
还ä¿�留了内分泌功能,并产生了æˆ�ç†Ÿç»„ç»‡å…·å¤‡çš„ç”Ÿç‰©æ´»æ€§æ¿€ç´ ï¼Œæ¯”å¦‚å�Œå—œé“¬ç»†èƒžç˜¤ã€‚
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