First, breast cancer examination items: molybdenum target X-ray film, tumor marker detection, breast B-ultrasound.
X-ray examination of breast cancer
The diagnostic rate of (1) molybdenum target photography for breast cancer can reach 80% ~ 90%. At present, there is no other method to replace the differential diagnosis of benign and malignant breast lesions and the early diagnosis of breast cancer. At present, there are two commonly used methods: molybdenum target and dry plate radiography. X-ray plain film should be considered as breast cancer when it has the following characteristics.
(2) Mammography: The image features can be caused by the infiltration, obstruction and destruction of cancer, resulting in the stiffness, local stenosis, irregular destruction or sudden interruption of the breast duct wall, or the abnormal distortion of the overall direction of the dendritic duct tree.
(3) mammography
(4)CT and MRI examination: CT examination may be helpful to find small and dense breast tumors, and MRI can also be used to find small breast cancer, both of which are superior to ordinary X-ray examination.
2. Ultrasonic image examination: Ultrasonic image examination is non-invasive and can be reused. It is valuable to use ultrasound imaging in patients with dense breast tissue, but its main purpose is to distinguish whether the mass is cystic or solid. The correct rate of ultrasound diagnosis of breast cancer is 80% ~ 85%. Images such as strong echo band formed by tumor infiltrating into surrounding tissues, normal breast structure destroyed, local skin thickening or depression above tumor are all important reference indexes for diagnosis of breast cancer.
3. Thermal image inspection: the image is used to display the temperature distribution on the body surface. Because of the rich blood supply of cancer cell proliferation block, the corresponding body surface temperature is higher than that of surrounding tissues, and the diagnosis can be made by using this difference. However, this diagnostic method lacks accurate imaging standards, the abnormal parts of heat do not correspond to tumors, and the diagnostic coincidence rate is poor, so it is less and less used in recent years.
4. Near-infrared scanning: On the monitor screen, you can see many shadows with gray centers ranging from light to dark gray or even black, which are larger than the actual mass, with unclear boundaries and irregular shapes. At the same time, there are abnormal vascular shadows around, which are rough, twisted, radial, banded, rat-tailed or tadpole-shaped (Figure 23).
5.CT examination: can it be used? It is helpful to make a treatment plan, locate breast lesions before biopsy, diagnose preoperative staging of breast cancer, and check whether lymph nodes in posterior region, axillary region and breast are enlarged.
6. Examination of tumor markers: In the process of canceration, tumor cells produce, secrete and directly release cell tissue components, which exist in tumor cells or host body fluids in the form of antigens, enzymes, hormones or metabolites. This substance is called a tumor marker.
Second, the examination items of cervical cancer: cervical curettage, gynecological examination and cervical conization biopsy.
1. Cervical smear cytology
It is the main method of cervical cancer screening and should be carried out in cervical transformation area.
2. Cervical iodine test
The squamous epithelium of normal cervix and vagina is rich in glycogen, and it is brown or dark brown after dyeing with iodine solution. The unstained area indicates that the epithelial cells lack glycogen and may have lesions. Biopsy in iodine-free areas can improve the diagnostic rate.
3. Colposcopy
If Pap cytology is grade III or above and TBS is classified as squamous intraepithelial neoplasia, cervical biopsy should be performed in the suspected canceration area under colposcopy.
4. Biopsy of cervix and cervical canal
To provide reliable evidence for the diagnosis of cervical cancer and cervical precancerous lesions. The removed tissues should include stroma and adjacent normal tissues. The cervical smear is positive, but the cervix is smooth or the cervical biopsy is negative. Scrape the cervical canal with a small curette and send the curette for pathological examination.
5. Cervical conization
It is suitable for those who have positive curettage and negative cervical biopsy; Or cervical biopsy of cervical intraepithelial neoplasia needs to exclude invasive cancer. Cold knife resection, circular electrotomy or condensation electrotomy can be used.
Ovarian examination items: ultrasound, laparoscopy, radiation diagnosis, etc.
If you have a disease like ovarian cancer, you must not ignore it. You should receive treatment as soon as possible. There are many ways to treat ovarian cancer in medicine. Patients are usually treated by surgery. Patients should be reexamined after the operation to observe their recovery. What are the reexamination items after ovarian cancer surgery?
1. Ultrasonic examination B-ultrasound imaging can detect the location, size, shape and nature of the mass.
2. Radiodiagnosis barium meal radiography or barium enema and air contrast radiography can know whether there is a tumor in the digestive tract. CT examination can locate and characterize pelvic tumors, and can know whether there is metastasis in liver, lung and retroperitoneal lymph nodes. Pelvic lymphadenography can judge that there is no lymphatic metastasis in ovarian tumor milk.
3. Laparoscopy can directly observe the source and general situation of the tumor, as well as the whole pelvic cavity and diaphragm, so as to determine the scope and staging of the lesion. Ascites can be aspirated for cytological examination, and suspicious tissues can also be taken for pathological examination. However, huge lumps or conglutinated lumps are taboo.
4. Cytological examination: Aspiration of ascites through abdomen or posterior fornix is helpful for the diagnosis of ovarian malignant tumor.
5. Detection of tumor markers The concentration of alpha-fetoprotein (aFP) in patients with embryonic cancer and endodermal sinus cancer is high, and it is positive when it is more than 20μ g/L. The determination of β-hCG has diagnostic value for primary ovarian choriocarcinoma and ovarian germ cell mixed choriocarcinoma. Radioimmunoassay of cancer antigen CA125 (positive when CA125 is greater than 65U/ml) has high diagnostic significance for epithelial cancer. The determination of lactate dehydrogenase (LDH) is helpful for the diagnosis of asexual cell tumors.
6. Abdominal exploration found that the ovaries were enlarged before puberty, and the ovaries could still be felt after menopause; Ovarian cystic tumor in women of childbearing age, with a diameter greater than 6cm, does not shrink or increase after 3 ~ 6 months of observation; Solid expansion
After ovarian cancer surgery, it is necessary to cooperate with Chinese medicine to consolidate treatment in time before it is possible to recover.