Thyroid cancer is the most common cancer of the endocrine system. The diagnosis of thyroid cancer has taken a step forward due to the introduction of fine-needle biopsy of the thyroid gland with subsequent evaluation of cytological material using the Bethesda system. One category of this classification traditionally remains a gray area of diagnosis. The detection of a follicular tumor in the cytological material (category IV according to Bethesda) does not allow one to reliably classify the neoplasia as benign or malignant and requires surgical intervention. The traditional informative and widely used method for diagnosing thyroid tumors is ultrasound. However, the sensitivity and specificity of the method varies over a wide range. This review analyzes the literature on the possibilities of ultrasound diagnostics in assessing the malignant potential of follicular tumors of the thyroid gland.
Bridging strategy (stoma/stents) may be a valid alternative in some patients with malignant colonic obstruction due to significantly reduced postoperative mortality. Acute surgery for malignant colonic obstruction should only be carried out by appropriately trained surgeons at multi-field hospital.
Our study showed that time of stent function corresponds to median survival. Greater number of stent migration in group 1 is due to stent coverage, higher incidence of stent dysfunction in group 2 - due to malignant invasion.
AIM: to work out and to implement multistage colorectal cancer treatment as a standard of surgical care in Moscow PATIENTS AND METHODS: Five-hundred seventy-two patients were included in the study reviewed: 247 of them were hospitalized in 2011-2013 (I group); 325-in 2014-2017 (II group). Forty-six patients underwent conservative treatment; 302-urgent bowel resection; 141-proximal stoma formation; 83-endoscopic stent insertion. One-hundred ten patients of the II group underwent elective bowel resection after 0,5-6 months and further chemoradiotherapy. The 3-year cumulative survival was assessed with Kaplan-Meier method. MultiStage treatment was implemented as a standard of surgical care in Moscow for colorectal cancer complicated by obstruction. Postoperative mortality and morbidity rate were estimated in 2014-2018 in Moscow. RESULTS. Complications occurred in 46,69 % (I group) and 21 % (II group) (p<0.05). Postoperative mortality was significantly higher in I group compared with II group: 26,11 % vs 10,33 % p<0.05). The survival rate was higher in II group than in I group (0,82 vs 0,69, p<0.05). The result was a decrease in postoperative mortality in Moscow from 22.4 % to 10.0 %. CONCLUSION: the efficacy of the new standard of medical care of colorectal cancer complicated by bowel obstruction is confirmed. A «bridge» strategy may be a valid alternative in these patients, because of significantly lower postoperative mortality and morbidity rate.
More than 90 % of newly diagnosed cases of endocrine cancer occur in the thyroid gland. Introduction of fine needle puncture of the thyroid gland, with the classification of cytological material according to the Bethesda system, has become the cornerstone of the diagnosis of malignant neoplasms of the thyroid gland. However, traditionally in this classification there remains a weak link called a follicular tumor (category IV). The detection of a follicular tumor in the cytological material does not allow one to reliably classify the mass as benign or malignant and requires surgical intervention with morphological verification. In recent years, the possibilities of molecular genetic testing have improved markedly. Follicular tumors tend to accumulate mutations, which over time can lead to malignant transformation, but can also be used as a method of timely diagnosis. This review analyzes the literature on the possibilities of molecular genetic testing in assessing the malignant potential of follicular formations of the thyroid gland.
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