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医学翻译——肿瘤分期系统

发布者:鑫达医学翻译 发布时间:2013-06-13 8:50:52 阅读:

原文:
Compared with traditional urothelial tumors, which arise from surface epithelium and grow outward, urachal tumors arise in the muscle wall or externally to the bladder and grow inward. Thus, the traditional staging system used for urothelial tumors does not apply. A broad staging system was initially proposed by Sheldon (BOX 2). Unfortunately, most patients present at stage III or higher, probably due to lack of symptoms, which may not develop until tumors are larger or have invaded through the muscle wall and surface epithelium sufficiently for recurrent gross hematuria to raise the alarm.
Recently, investigators at the Mayo Clinic (MN, USA) proposed an alternative, more simplistic staging system: Stage I, confined to urachus bladder; Stage II, beyond urachus/bladder; Stage III, regional lymph nodes; and Stage IV, distant lymph nodes/metastases. However, the distinction between stage III and IV of the Mayo system seems somewhat artificial since there is no difference in survival when comparing patients with localized lymph nodes and distant metastases. Previously published data from MDACC also suggest similar survival of approximately 2 years when comparing lymph node metastases with distant metastases. Unfortunately, with only limited numbers of patients with urachal cancer, neither staging system
can be validated easily.

译文:
与传统尿路上皮肿瘤相比(产生于表面上皮并向外生长),脐尿管肿瘤起始于肌肉壁或膀胱外,向内生长。因此,用于尿路上皮肿瘤的传统分期方法不再适用。最初由Sheldon提出一个宽泛的分期系统(表2)。遗憾的是,多数处于III期或更晚期的患者可能由于缺乏症状,直到肿瘤变大或充分穿透肌肉壁和表面上皮,并出现血尿症状。
最近,美国明尼苏达州的梅奥诊所(Mayo Clinic)提出另一个更为简单的分期系统:I期,限于脐尿管及膀胱内;II期,超出脐尿管/膀胱;III期,局部淋巴结;IV期,远端淋巴结/转移。然而,梅奥系统对于III期和IV期的划分似乎有些人为化,因为局部淋巴结和远端转移的患者相比并没有生存差异。之前从安德森癌症中心(MDACC)发布的数据也提示,淋巴结转移和远端转移患者相比情况类似,即具有约2年的生存时间。遗憾的是,脐尿管癌患者数量极为有限,因而没有一种确切的分期系统。


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