简介:目的探讨微小型甲状腺乳头状癌颈淋巴转移的临床意义.方法回顾性分析1998年5月~2001年12月住院治疗的27例微小型甲状腺乳头状癌患者,其中23例行颈清扫术,并与同期住院治疗的144例非微小型甲状腺乳头状癌进行对比.结果微小型与非微小型甲状腺乳头状癌颈部淋巴结转移分别为12/23(52.2%)、108/144(75.0%),淋巴结阳性率分别为29.7%、37.8%;Ⅵ区淋巴结转移分别为9/23(39.1%)、43/58(74.1%),淋巴结阳性率分别为32.0%、58.4%;Ⅰ-Ⅴ区淋巴结转移分别为11/23(47.8%)、93/144(64.6%),淋巴结阳性率分别为15.2%、34.9%,三者统计学均有显著性意义.10例临床颈部N0微小型甲状腺乳头状癌患者,6例病理检查发现淋巴结转移.结论微小型甲状腺乳头状癌患者颈淋巴结转移比非微小型低,以颈静脉链为常见部位,其次是气管食管沟.对一个确诊为微小型甲状腺乳头状癌患者,都应行颈清扫术.
简介:AIM:Toaddressissuesininteroperabilitybetweendifferentfundusimagesystems,weproposedawebeyepicturearchivingandcommunicationsystem(PACS)frameworkinconformancewithdigitalimagingandcommunicationinmedicine(DICOM)andhealthlevel7(HL7)protocoltorealizefundusimagesandreportssharingandcommunicationthroughinternet.METHODS:Firstly,atelemedicine-basedeyecareworkflowwasestablishedbasedonintegratingthehealthcareenterprise(IHE)EyeCaretechnicalframework.Then,abrowser/serverarchitectureeye-PACSsystemwasestablishedinconformancewiththewebaccesstoDICOMpersistentobject(WADO)protocol,whichcontainsthreetiers.RESULTS:Inanyclientsysteminstalledwithwebbrowser,clinicianscouldlogintheeye-PACStoobservefundusimagesandreports.Multipurposeinternetmailextensions(MIME)typeofastructuredreportissavedaspdf/htmlwithreferencelinktorelevantfundusimageusingtheWADOsyntaxcouldprovideenoughinformationforclinicians.Somefunctionsprovidedbyopen-sourceOviyamcouldbeusedtoquery,zoom,move,measure,viewOICOMfundusimages.CONCLUSION:Suchwebeye-PACSincompliancetoWADOprotocolcouldbeusedtostoreandcommunicatefundusimagesandreports,thereforeisofgreatsignificanceforteleophthalmology.