间皮瘤的诊断技术

  Imaging Techniques | Pathology Tests | Pulmonary Function Tests

影像 病理 肺功能测验

The early detection of mesothelioma is critical to the patient’s outlook and in determining applicable treatment options. However mesothelioma is often difficult to diagnose for a variety of reasons. Because mesothelioma is a rare disease many doctors are not familiar with it. In addition the non-specific nature of mesothelioma symptoms can be indicators of other medical conditions. The extended length of time between asbestos exposure and a patient’s symptomatic responses between 10-70 years further hinders immediate detection of mesothelioma. Despite these difficulties there are many procedures available for the accurate diagnosis of mesothelioma.

早期发现间皮瘤对病人的前景及决定合适的治疗选择是要害的。然而，因种种原因间皮瘤常难以诊断。因为间皮瘤是一个罕见病，许多医生对它不认识。另外，间皮瘤的非特异性症状也指示其它医学状态的。石棉暴露和病人症状反映间的最长时间是10-70年，进一步影响间皮瘤即刻诊断。

Initial uation of Mesothelioma Symptoms间皮瘤症状的初始评价
The initial patient uations are critical in identifying patients at risk for developing mesothelioma. To establish risk factors and the presence of symptoms your physician will complete a medical history that includes questions to help determine the timeframe and environment in which you may have been exposed to asbestos. Communication between the patient and doctor is important so that the earliest possible detection of mesothelioma can be made. Make certain that you have shared all relevant information regarding previous work history and possible asbestos exposure with your physician.

病人的初始评估在识别发展间皮瘤的危险性是关键的。为确定危险因素和存在的症状，你的内科医生将完成一个病历包括助于确定表和你可能已暴露石棉的环境的问题。病人和医生间的交流如此重要以至于早期可能发现早期间皮瘤。确信你把所有你以前工作史相关信息和可能的石棉暴露告知你的医生。

In addition to constructing a medical profile and detailed medical history a complete physical examination will be performed. During a physical exam your doctor may look for the following:

此外构建医学简介和具体的病史，需进行完整的体格检查。在体格检查中你的医生可能观察以下：

· Breath Sounds: by listening to the chest cavity as the patient inhales and exhales the doctor may note an absence of breath sounds or note these sounds may be muted. The absence of or muted nature of these breath sounds may be an indication of fluid in the chest cavity or of pleural effusions.

· 呼吸音：通过听病人吸气和呼气时的呼吸音，医生可能注重到呼吸音的消失或减弱。这可能提示胸腔积液。

· The doctor may listen to the chest cavity while having the patient make vowel sounds - comparing the sound resonance in the right and left chest cavities. Muted or dull sounds between the cavities could be an indicator of a buildup of fluid.

· 医生在病人发元音时听左右胸腔的语音共振。沉静的或沉闷的可能提示液体的聚积。
· By tapping on the chest area a doctor may notice a dull solid thumping sound rather than a hollow resonance. This may also indicate the presence of fluid or a mass in the chest cavity.

· 叩诊胸部医生可能留意到浊的、实音，而不是清音。这可能也提示胸腔液体或肿块的存在。

· A physical examination will also check for enlarged lymph nodes.

· 体格检查也可发现增大的淋巴结。

There are often very few signs during an initial physical exam that would identify the presence of mesothelioma. On the basis of patient symptoms medical history the presence of specific risk factors (work environment asbestos exposure) and a complete physical examination the doctor can use one or more of the methods described below to determine if the disease is present.

可识别间皮瘤的体征在最初的体格检查很少。依据病人的症状、病史和特别的危险因素（工作环境、石棉暴露），一个全面的体格检查，医生可应用以下一个或更多的方法确定疾病是否存在。

Doctors use a variety of diagnostic procedures to determine if a patient has mesothelioma. Comparing results from imaging scans tissue biopsies pulmonary function tests and other diagnostic techniques the presence of mesothelioma can be identified.

医生应用种种诊断性程序决定病人是否有间皮瘤。通过比较影像结果、组织活检、肺功能测定和其它的诊断性技术，间皮瘤可被识别。

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Diagnostic Tests for Mesothelioma: Imaging Techniques间皮瘤的诊断性：影像技术
There are many available technologies that allow doctors to view or image organs and tissue that might show the presence of fluid or tumors

有很多可用的技术可使医生发现可能表现液体或肿瘤的器官和组织。

Chest X-Ray 胸部X-线

A chest x-ray may show an unusual thickening of the pleura lowering of the lung fissures (spaces between the lobes of the lungs) an accumulation of fluid in the lungs (pleural effusion) and/or an irregular mass in the chest cavity.

胸部X-线可能表现胸膜不正常的增厚，肺间隙降低（肺叶间的空间），肺病液体的聚集（胸腔积液），和/或胸腔不规则肿块。

Computed Tomography (CT) Scan CT扫描

A computed tomography (CT) scan uses x-rays and computers to give more sophisticated and detailed pictures of the insides of our body than conventional x-rays. A rotating x-ray beam is used to take a series of pictures of the body from different angles. A computer combines the series of pictures to produce a detailed cross-sectional image of a specific part of the body. The CT scan allows a radiologist to see distinct aspects of the lungs and pleura.

CT扫描应用X-线和计算机产生比常规X-线更精细和详细的体内图片。旋转的X-线束从不同角度摄取机体一系列图片。计算机把这些相片整合以产生体内特别部位的详细的横断面影像。CT扫描使影像学家看到肺和胸膜更清楚地图像。

Magnetic Resonance Imaging (MRI) 磁共振

Magnetic Resonance Imaging (MRI) uses a strong magnetic field and radiowaves to scan the body. There is no radiation involved. This imaging method produces a series of cross-sectional pictures. MRI scans are useful for viewing soft tissues in the body and can show the extent of mesothelioma. New MRI techniques where surface imaging techniques are combined with quick breath-holding sequences and gadolinium contrast medium give images which detect tumor growth in the pleura and thoracic wall better than the previous methods. MRI images tend to be quite clear and are superior to routine x-ray images.

磁共振应用强磁场和磁波扫描机体。没有射线。这个影像技术产生一系列横断面图像。磁共振扫描对观察机体软组织有用，并能显示间皮瘤的范围。新的磁共振技术。当表面影像技术结合快相屏气序列和钆造影剂，较前面的方法更好的发现胸膜和胸壁上的肿瘤生长。磁共振好像更清晰且比常规X-线影像优越。

Positron Emission Tomography (PET) Scan正电子放射层扫描术PET

Positron Emission Tomography (PET) scans use a camera that produces powerful images of the body’s biological functions. Because cancers and other disease processes metabolize sugars at a higher rate than normal tissues or organs the PET scan uses tracers to indicate where there is abnormal metabolic activity and can pinpoint the regions of active disease. PET scans can also identify extremely small cancerous cells indicate benign or malignant cells and help determine whether treatment therapies are working.

PET应用产生强盛图像的人体生理功能的相机。由于癌症和其它的疾病糖类代谢率远高于正常组织或器官，PET应用示踪剂显示不正常的代谢活动并能指出活动病变区域。也可识别极小的肿瘤细胞，显示良性或恶性细胞，帮助判定治疗疗效。

Mesothelioma is diagnosed by pathological examination where tissue is removed and put under the microscope. A pathologist then makes a definitive diagnosis and issues a pathology report.

间皮瘤通过病理学检查诊断，组织移除并放在显微镜下观察。病理学家于是作出决定性的诊断和作出病理报告。

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Diagnostic Tests for Mesothelioma: Pathology Tests间皮瘤诊断：病理学检查
Thoracoscopy 胸腔镜检查

A tissue sample of a pleural or pericardial tumor can be obtained using a relatively new technique called thoracoscopy. A thoracoscope (telescope-like instrument connected to a video camera) is inserted through a small incision into the chest. The doctor can see the tumor through the thoracoscope and can use special forceps to take a tissue biopsy.

胸膜或心包组织样本可通过应用相对较新的技术胸腔镜获取。胸腔镜（望远镜样器械连接一个摄像机）通过一个小切口进入胸腔。医生通过它可看到肿瘤组织并用非凡的镊子取组织活检。

Laparoscopy 腹腔镜检查

A laparoscopy can be used to see and obtain a biopsy of a peritoneal tumor. In this procedure a flexible tube is attached to a video camera that is inserted into the abdominal cavity via small incisions. Fluid can also be collected during thoracoscopy or laparoscopy.

腹腔镜可用于观察和获取腹膜肿瘤的活检。在这个过程中，一个柔性管连接摄像机通过小的切口进入腹腔。在胸腔镜和腹腔镜检查时可抽取液体。

Bronchoscopy 支气管镜检查

A bronchoscopy may be performed if pleural mesothelioma is suspected. In this process the doctor inserts a flexible lighted tube down the trachea and into the bronchi to check for masses in the airway. At that time small samples of abnormal-appearing tissue may also be removed for testing.

假如怀疑胸膜间皮瘤，也可用支气管镜检查。在这个过程中，医生顺着气管插入柔性轻管，进入支气管检查气道中肿块。那时，异常组织的小的样本可获取用于检查。

Mediastinoscopy 纵隔镜检查

Lymph nodes are collections of immune system cells that help the body fight infection. By examining the lymph nodes the doctor can determine if the cancer has spread. During a mediastinoscopy a patient has a lighted tube inserted under the sternum (chest bone) at the neck level and then moved down into the chest. The surgeon can see the lymph nodes and take tissue samples to check for cancer. This procedure can also help the physician determine if you have lung cancer or mesothelioma.

淋巴结汇集帮助机体对抗感染的免疫细胞。通过检查淋巴结，医生可发现肿瘤是否播散。在纵隔镜检查中，病人在颈部水平插入一个轻管进入胸骨下，然后移入胸腔。外科医生可以看到淋巴结并获取组织样本用于检查。这也可帮助内科医生发现是肺癌或是间皮瘤。

The last set of tests in diagnosing mesothelioma are the pulmonary function tests.

最后诊断间皮瘤的系列检查是肺功能测定。

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Diagnostic Tests for Mesothelioma: Pulmonary Function Tests间皮瘤诊断性检查：肺功能测定
Pulmonary Function Tests (PFTs) 肺功能测定

PFTs encompass a wide variety of tests that uate the entire respiratory system. The tests are useful in the assessment and diagnosis of pulmonary disease and aid in determining a course of treatment. PFTs can be a simple peak flow measurement or complex body plethysmography and ventilation/perfusion scans which are performed in hospitals and clinics. PFTs can also be useful in monitoring patient response to treatment.

肺功能测定是一个广泛的评估整个呼吸系统的检查。它有助于评估和诊断肺部疾病并助于决定治疗。它是一个简朴的峰流测定，机体体积描述计和气流关注的综合检查，可以再医院和门诊进行。也有助于检查病人对治疗的反应。

Although Mesothelioma can often be difficult to initially detect the above medical procedures and diagnostic tests can lead to a clear diagnosis. Early medical diagnosis is one of the primary variables affecting long-term prognosis.

尽管间皮瘤最初难以发现，以上的医学程序和检查手段可以作出明确的诊断。早期诊断是一影响长期预后的主要变量之一。