儿童恶性肿瘤及其治疗对患儿生育力的潜在影响是儿童癌症幸存者(childhood cancer survivors,CCS)及家庭关注的重要问题,而这很大程度上取决于患儿治疗时的年龄和治疗方案的选择。恶性肿瘤患儿的生育力保存存在社会认知不足,医患观念差...儿童恶性肿瘤及其治疗对患儿生育力的潜在影响是儿童癌症幸存者(childhood cancer survivors,CCS)及家庭关注的重要问题,而这很大程度上取决于患儿治疗时的年龄和治疗方案的选择。恶性肿瘤患儿的生育力保存存在社会认知不足,医患观念差异以及可供选择的生育力保存方法相对有限,使得患儿生育力保存的实施面临诸多困难。本文针对不同治疗方式在恶性肿瘤患儿生育力保存的使用现状、作用机制和危害程度,以及如何预防和控制生育力损害进行阐述,以期合理用药,保存恶性肿瘤患儿生育力。展开更多
Background Detection rate of retropharyngeal lymph node metastasis in patients with nasopharyngeal carcinoma （NPC） needs to be improved. The purpose of this study was to compare three magnetic resonance （MR） seque...Background Detection rate of retropharyngeal lymph node metastasis in patients with nasopharyngeal carcinoma （NPC） needs to be improved. The purpose of this study was to compare three magnetic resonance （MR） sequences for detecting lymph nodes in patients with NPC. Methods Between July 2007 and March 2008, MR staging of pre-treated tumor was conducted on 120 patients with pathologically confirmed NPC. The outcome of three different sequences for MR NPC staging were compared： coronal short T1 inversion recovery （STIR）, axial proton density fat-suppressed （PDWI fs）, and coronal contrast enhanced fast spin echo T1 weighted fat-suppressed （CE FSE TlWl fs）. Nodal classification method （1999） was applied to count the number of retropharyngeal and cervical lymph nodes discovered by each MR sequence. Paired t tests were used for statistical analysis. Results A total of 2575 lymph nodes were found using coronal STIR sequence; 1816 lymph nodes for coronal CE FSE TIWI fs sequence and 2638 lymph nodes for axial PDWl fs sequence. Significant differences existed in the number of lymph nodes detected by axial PDWI fs and coronal CE FSE T1WI fs sequence （paired t test, P 〈0.05）, with the former sequence getting higher numbers. Statistical differences also existed between coronal STIR and coronal CE FSE TlWl fs sequence （paired ttest, P 〈0.05）, with the former sequence getting higher numbers. No significant difference was found between coronal STIR sequence and axial PDWI fs sequence （paired ttest, P 〉0.05）. Conclusions For the detection of retropharyngeal and cervical lymph nodes, coronal STIR sequence and axial PDWI fs sequence have similar performance and both sequences showed better detection than CE FSE TIWI fs sequence. Furthermore, by combining coronal STIR sequence and axial PDWI fs sequence, we can improve the detection of lymph nodes in NPC N-staging before treatment, especially for lymph nodes located in the thoracic entrance.展开更多
文摘儿童恶性肿瘤及其治疗对患儿生育力的潜在影响是儿童癌症幸存者(childhood cancer survivors,CCS)及家庭关注的重要问题,而这很大程度上取决于患儿治疗时的年龄和治疗方案的选择。恶性肿瘤患儿的生育力保存存在社会认知不足,医患观念差异以及可供选择的生育力保存方法相对有限,使得患儿生育力保存的实施面临诸多困难。本文针对不同治疗方式在恶性肿瘤患儿生育力保存的使用现状、作用机制和危害程度,以及如何预防和控制生育力损害进行阐述,以期合理用药,保存恶性肿瘤患儿生育力。
基金This study was supported by a grant from the Natural Science Foundation of Fujian Province （No. 2004Y008）.
文摘Background Detection rate of retropharyngeal lymph node metastasis in patients with nasopharyngeal carcinoma （NPC） needs to be improved. The purpose of this study was to compare three magnetic resonance （MR） sequences for detecting lymph nodes in patients with NPC. Methods Between July 2007 and March 2008, MR staging of pre-treated tumor was conducted on 120 patients with pathologically confirmed NPC. The outcome of three different sequences for MR NPC staging were compared： coronal short T1 inversion recovery （STIR）, axial proton density fat-suppressed （PDWI fs）, and coronal contrast enhanced fast spin echo T1 weighted fat-suppressed （CE FSE TlWl fs）. Nodal classification method （1999） was applied to count the number of retropharyngeal and cervical lymph nodes discovered by each MR sequence. Paired t tests were used for statistical analysis. Results A total of 2575 lymph nodes were found using coronal STIR sequence; 1816 lymph nodes for coronal CE FSE TIWI fs sequence and 2638 lymph nodes for axial PDWl fs sequence. Significant differences existed in the number of lymph nodes detected by axial PDWI fs and coronal CE FSE T1WI fs sequence （paired t test, P 〈0.05）, with the former sequence getting higher numbers. Statistical differences also existed between coronal STIR and coronal CE FSE TlWl fs sequence （paired ttest, P 〈0.05）, with the former sequence getting higher numbers. No significant difference was found between coronal STIR sequence and axial PDWI fs sequence （paired ttest, P 〉0.05）. Conclusions For the detection of retropharyngeal and cervical lymph nodes, coronal STIR sequence and axial PDWI fs sequence have similar performance and both sequences showed better detection than CE FSE TIWI fs sequence. Furthermore, by combining coronal STIR sequence and axial PDWI fs sequence, we can improve the detection of lymph nodes in NPC N-staging before treatment, especially for lymph nodes located in the thoracic entrance.
