病理诊断在临床多学科诊疗中的应用
摘要
多学科诊疗(MDT)模式有效地提高了肿瘤诊断和治疗的效率,也是世界各国处理不同肿瘤的最有效的一种模式。由于肿瘤的高度复杂性和异质性,诊断需要内科、外科、病理、核医学等多学科间的合作,治疗涉及手术、放疗、化疗等多种方式。需要MDT讨论整合多学科资源,制定治疗计划,提高患者生活质量和延长生命。病理医生作为MDT成员,参与MDT例会,有助于解决临床诊疗中碰到的难题,优化病理科工作、提高病理诊断水平。在MDT临床实践中,病理诊断不仅提供更精准的诊断,也有助于临床医师制定更好的诊疗方案,更重要的是促进肿瘤等难治性疾病的治疗,同时在MDT讨论中也有利于病理诊断和科研水平的提高。
引文
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[3] Taylor C,Atkins L,Richardson A,et al.Measuring the quality of MDT working :an observational approach[J].BMC Cancer,2012,12:202.
[4] Choi JI,Joo I,Lee JM.State-of-the-art preoperative staging of gastric cancer by MDTC and magnetic resonance imaging[J] .World J Gastroenterol,2014,20(16):4546-4557.
[5] National Comprehensive Cancer Network.NCCN clinical practice guidelines in oncology :gastric cancer[EB/OL].V.1.2011 NCCN,2011.http://www.nccn.org.
[6] Chen XZ,Yang K,Zhang B,et al.Is retrieval of >25 lymphnodes a superior criterion for locally advanced gastric cancer surgery?[J].Ann Surg,2011,254(5):834-835.
[7] Bang YJ,Van Cutsem E,Feyereislova A,et al.Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA):a phase 3,open-label,randomised controlled tria [J].Lancet,2010,376(9742):687-697.
[8] Nozaki I,Hato S,Kobatake T,et al.Long-term outcome after proximal gastrectomy with jejunal interposition for gastric cancer compared with total gastrectomy [J].World J Surg ,2013,37(3):558.
[9] Tan VP,Wong BC.Gastric cancer chemoprevention :the current evidence[J].gastroenterol Clin North Am,2013,42:299-316.
[10] Gaga M,Powell C,et al.An official American Thoracic Society/European Respiratory Society statemen of lung cancer[J].Am J Respir Crit Care Med,2013,188(4):503-507.
[11] Ung KA,Campbell BA,Duplan D,et al.Impact of the lung oncology multidisciplinary team meetings on the management of patients with cancer [J].Asia Pac J Clin Oncol,2016,12(2):e298.